The gluten-free diet food market has burgeoned in recent years – estimated at $8.8 billion in 2014 according to research from Mintel. Items that were once only available at specialty stores, through mail order or by home preparation are now easily accessible at most grocery stores and even some smaller food markets. While a diverse group of consumers who purchase gluten-free diet food reap the benefits, this is especially great news for people with celiac disease, who for health reasons must not consume any gluten-containing foods.
Celiac disease is an autoimmune disorder triggered by the ingestion of proteins from wheat, rye and barley in individuals who are genetically predisposed. These proteins are collectively referred to as gluten. When gluten is ingested, it causes an abnormal immune response that leads to damage to the lining of the small intestine. This, in turn, prevents nutrients from being absorbed from food. Symptoms of celiac disease vary greatly and may include anemia, diarrhea, bone pain, skin rash, brain fog, or any of over 300 symptoms. Left untreated, celiac disease can lead to the development of other autoimmune disorders like type 1 diabetes, osteoporosis and anemia, and intestinal cancers. The prevalence of celiac disease in the United States is about 1%.
Non-Celiac Gluten Sensitivity (NCGS)
Some people may be sensitive to gluten but do not have celiac disease. This is known as non-celiac gluten sensitivity, or NCGS. NCGS has emerged more frequently in clinically settings over recent years and individuals with self-reported NCGS appear to outnumber those with celiac disease.
NCGS is associated with symptoms that are experienced in response to the ingestion of foods containing wheat, rye, and barley. Symptoms may be similar to celiac and include abdominal pain, headaches, tingling or numbness in hands and feel, fatigue, musculoskeletal pain and “brain fog”. Other symptoms such as diarrhea and rash have also been reported. Non-celiac gluten sensitivity symptoms resolve themselves following the elimination of gluten-containing foods. Some experts think as many as 1 in 20 Americans may have some form of NCGS.
Diagnosis of NCGS
A blood test for gluten sensitivity does not currently exist so the only way to be diagnosed is to undergo the screening and diagnostic tests necessary to confirm celiac disease. Gluten sensitivity is confirmed when a diagnosis for celiac is ruled out and symptoms lessen after beginning a gluten-free diet. Symptoms return when gluten is reintroduced.
If you experience symptoms following the ingestion of gluten-containing food, it is important to speak with your physician about testing before beginning a gluten-free diet.
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Fasano A, Sapone A, et al. Gastroenterology. 2015 May;148(6):1195-204. Epub 2015 Jan 9.