What is non-celiac gluten sensitivity?

Gluten is a protein found in wheat, rye, barley, and some other grains and foods. If you have gluten sensitivity or intolerance, you have a reaction, such as upset stomach or gas when you eat foods that contain gluten.

Gluten sensitivity is not the same as an allergy or celiac disease. If you have an allergy to wheat, rye, or barley, eating these foods can cause hives, swelling, dizziness, or trouble breathing. If you have celiac disease, eating gluten damages the lining of the small intestine and makes it hard for your intestines to absorb nutrients from food.

What is the cause?

The exact cause of non-celiac gluten sensitivity is not known.

What are the symptoms?

Some people start having symptoms as children, others later in life. The symptoms vary a lot from one person to the next.

Digestive symptoms may include:

• Belly pain or cramps
• Gas and bloating
• Diarrhea or constipation

Other symptoms may happen hours or days after you eat gluten and involve other parts of the body. These symptoms may include:

• Feeling unusually tired
• Headache
• Joint pain
• Numbness in the legs, arms, or fingers
• Trouble focusing and concentrating

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. There is no test for gluten sensitivity. You may have tests to check for other problems, such as allergies or celiac disease. These tests may include:

• Blood tests
• Biopsy, which is the removal of a small sample of tissue from the intestine for testing

If these tests are normal, your provider may suggest that you stop eating any foods that contain gluten and see if your symptoms get better. If your symptoms do get better, your provider may want you to try food with gluten again to see if your symptoms come back.

How is it treated?

The only treatment for gluten sensitivity is a gluten-free diet. For most people, this diet relieves symptoms in a few weeks.

What is a gluten-free diet?

A gluten-free diet contains no wheat, barley, or rye. Because the American diet is based on grains and many processed foods contain grain-based additives, this diet can be hard to follow. You may need to work with a dietitian to help you eat a healthy, gluten-free diet. Here are some suggestions:

• Grains are high in carbohydrates, also called carbs, which are a source of energy and nutrients. It is important to replace carbs from wheat, rye, and barley with carbs from foods such as wild rice, quinoa, millet, corn, and potatoes.
• Fresh fruits, vegetables, beans, milk, fresh beef, pork, poultry, fish, and eggs do not contain gluten. Nuts, seeds, and vegetable oils without additives are also safe.
• Any product with a “gluten-free” label is usually OK to eat. Some food products are certified by the Gluten Free Certification Organization (GFCO) and have a GFCO stamp on them. The GFCO tests for the amount of gluten in a product and has strict standards.
• Always read labels to check for gluten, but remember that “wheat free” doesn’t always mean “gluten free.” Wheat-free products may contain barley or rye.
• Many companies will send you a list of their gluten-free products. If you have any question about whether a food contains gluten, avoid the product until you check with the manufacturer.
• When you eat at a restaurant or deli, ask if they have a gluten-free menu. Order foods without sauces since wheat flour is used as a thickener in many sauces.

Your healthcare provider may prescribe a daily gluten-free multivitamin and mineral supplement. Ask your pharmacist or call the manufacturer to find out about the ingredients in your medicine.

Ask your healthcare provider:

• How and when you will hear your test results
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.