Gluten gastrointestinal symptoms in non-celiac disease!

For those of you who are my patients, you can tune me out in this post. I have talked ad nauseam about the con­nec­tion between glu­ten intol­er­ance and irrit­able bowel syn­drome. If celi­ac dis­ease has been ruled out through con­ven­tion­al blood pan­els, most of the time people are left con­fused and still in dis­com­fort as there are symp­toms like bloat­ing, gas, skin rashes, or gen­er­al feel­ing of leth­argy and mal­aise after eat­ing products with wheat. The ques­tion is, why? Why are these symp­toms being per­ceived but not being caught by con­ven­tion­al blood test­ing?

A group of gast­roen­ter­o­lo­gists in Australia have gone a step fur­ther to invest­ig­at­ing this rela­tion­ship. In con­ven­tion­al meth­ods of test­ing for react­iv­ity to glu­ten, a study was pub­lished with the American Journal of Gastroenterology in which a double-blind ran­dom­ized con­trolled group of 34 indi­vidu­als were either sub­jec­ted to eat­ing glu­ten for 6 weeks and those not (placebo) for 6 weeks. After 6 weeks, there were sig­ni­fic­ant changes in the group eat­ing wheat, with para­met­ers meas­ured and com­pared to the placebo group includ­ing increased pain, bloat­ing, unstable stool (feces) con­sist­ency, and gen­er­al tired­ness. Blood test­ing for anti-gli­ad­in anti­bod­ies (the pro­tein com­pon­ent of wheat) were tested, but did not prove to show up for the glu­ten-eat­ing group. Additionally, there were no sig­ni­fic­ant changes in fecal lacto­fer­rin (a mark­er of inflam­ma­tion spe­cif­ic to the intest­ine), levels of celi­ac anti­bod­ies (our body’s response to a food that is con­sidered for­eign and worthy of “attack”), highly sens­it­ive C-react­ive pro­tein, or intest­in­al per­meab­il­ity.

Despite all of the blood tests prov­ing neg­at­ive, it was undeni­able that there were symp­tom changes to those eat­ing glu­ten with IBS and they were in dis­com­fort. Perhaps they were look­ing at the wrong mark­ers in the body to judge this? Gluten intol­er­ance is per­haps more what was being observed, as I have pre­vi­ously pos­ted upon (as I men­tioned, ad nauseam!). Positively, it was not per­ceived that these patients were ima­gin­ing their symp­toms, which I think is point­ing sci­ence in the right dir­ec­tion!

Wheat Belly, a book recently pub­lished by med­ic­al doc­tor Dr. Davis, out­lines the import­ance of glu­ten and its abil­ity to affect immune func­tion­ing and the patency of the gastrointest­in­al tract. Don’t believe me? Read about it! All in the facts.

A spe­cial thank you to Galen’s Watch for their dili­gence in comb­ing the lit­er­at­ure for altern­at­ive medi­cine stud­ies and their effic­acy, and a friend Mark Mulholland who shares my wheat and glu­ten pas­sion.

References

Biesiekierski JR, Newnham ED, Irving PM, Barrett JS, Haines M, Doecke JD, Shepherd SJ, Muir JG, Gibson PR.
Gluten causes gastrointest­in­al symp­toms in sub­jects without celi­ac dis­ease: a double-blind ran­dom­ized placebo-con­trolled tri­al.
Am J Gastroenterology. 2011 Mar;106(3):508 – 14; quiz 515. Epub 2011 Jan 11.

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