Diet diary : Non-celiac gluten intolerance — silent trouble

By : Ishi Khosla

GLUTEN — a protein in wheat, oats, barley and rye (European cereal) — is known to cause a condition called celiac disease. It is a condition in which gluten damages the intestines and reduces the ability of intestines to absorb food. The individuals with this condition can manifest typical or atypical symptoms or may have hardly any symptoms also called silent celiacs.

Typical symptoms of celiac disease include diarrhoea, gastrointestinal disturbances like abdominal distension, bloating, burping, reflux, flatulence, pain, constipation; nausea, vomiting; growth problems; stunting, weight loss; anaemia, lethargy, tiredness, but not everyone has these.

Absence of typical symptoms makes the diagnosis difficult and often leads to ill health and life threatening maladies. Celiac disease can creep up silently on just about anyone – across age, gender, class and race — and turn fatal if undiagnosed. Celiac disease is diagnosed through a simple blood test and confirmed through the gold standard intestinal biopsy, which shows damage to the intestinal lining (villi).

However, another form of sensitivity to wheat called non-celiac gluten sensitivity (NCGS) has been identified. The relatively new entity is now being recognized by healthcare practitioners and it is important to understand the difference between these conditions even though they may all respond to a gluten-free diet. You may develop it at any age even if you have been consuming gluten all your life.

Non-celiac gluten sensitivity has been coined to describe those individuals who cannot tolerate gluten and experience symptoms similar to those with celiac disease but who lack the same antibodies and intestinal damage as seen in celiac disease. Research suggests that non-celiac gluten sensitivity is an innate immune response, as opposed to an autoimmune or allergic reaction. Individuals with non-celiac gluten sensitivity may also have a high prevalence of extra-intestinal or non-gastro-intestinal symptoms such as headache, “foggy mind,” joint pain, and numbness in the legs, arms or fingers. Symptoms typically appear hours or days after gluten has been ingested.

Individuals with non-celiac gluten sensitivity would also not test positive for celiac disease based on blood testing, nor do they have the same type of intestinal damage found in individuals with celiac disease. Some individuals may experience minimal intestinal damage, and this goes away with a gluten-free diet.

The word of caution is to seek professional help, if in doubt. Self diagnosis and going off gluten can lead to a missed diagnosis of more serious celiac disease. Although gluten-free diets are gaining popularity and are warranted in celiac disease and non-celiac gluten intolerance, it must not become a fad.

Ishi Khosla is a former senior nutritionist at Escorts. She heads the Centre of Dietary Counselling and also runs a health food store. She feels that for complete well-being, one should integrate physical, mental and spiritual health. According to her: “To be healthy should be the ultimate goal for all.”

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