Contributor: Leonard Calabrese, DO
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Do you experience discomfort or pain when you eat foods containing gluten — but when your doctor runs tests, they come back negative for both celiac disease and food allergies?
For years, medical professionals have argued, confirmed and debunked the idea that people could be sensitive to gluten when they do not test positive for celiac disease.
It’s been a mystery. Why do millions of patients who go gluten-free experience relief of their symptoms of abdominal pain, bloating, diarrhea, fatigue, headache and even brain fog?
When considering celiac disease as a possible culprit, doctors search for specific signs. They consider a person’s genetics, environment and immune system. With a lack of evidence of celiac disease, many doctors have dismissed a response to gluten as, at best, another bowel or autoimmune disorder, or at worst, clever marketing influencing people to blame their symptoms on the latest craze.
Provocative new research
Recent research is providing clarity. It offers new evidence supporting the existence of a condition called non-celiac gluten sensitivity (NCGS), which is distinct from both celiac disease and food allergies.
In the study, a group from Columbia University, led by Armin Alaedini, PhD, conducted a carefully controlled experiment performed on patients who reported sensitivity to gluten. These were patients for whom celiac disease and food allergy were soundly ruled out.
Participants were given gluten and then assessed for signs of intestinal cell damage, inflammation and other signs of a triggered immune system. They were compared to two other groups, one with well documented celiac disease and the other, healthy controls.
What researchers found was quite provocative, significant scientific evidence for NCGS. Unlike those with celiac disease or healthy controls, the NCGS group had significant elevations of soluble CD14 and lipopolysaccharide-binding protein. What this means is that they had various signs of abnormal gut flora from their bowel, or what some have called “leaky gut.” The NCGS group also showed additional signs of their immune system being triggered throughout the body.
Other unexplained disorders
This clearly provides objective evidence that people without celiac disease can suffer from problems when they consume gluten, namely systemic inflammation and damage to the cells that line the intestines.
The findings are also compelling for the investigation of those with other medically unexplained disorders, such as such as chronic fatigue syndrome.
So far, we don’t have biomarkers for NCGS, or a way to search for it specifically in a medical test, but I think we are ready for clinical discovery based on searching for signs of an immune system that is amped up, along with bowel injury.