what is gluten sensitivity?

(photo: commons.wikimedia)
(photo: commons.wikimedia)

A recent article from ScienceNews.org provides a better overview of the challenges related to gluten sensitivity.

Excerpt from ScienceNews.org:

There are two well-established conditions that require people to avoid gluten. Celiac disease, an immune response to gluten that produces severe inflammation of the small intestine, afflicts about 0.75 percent of the population.  A wheat allergy, sometimes called baker’s asthma, affects about 0.4 percent of the population and is usually characterized by symptoms like breathing problems and a runny nose.

But gluten sensitivity in people who don’t have celiac disease or a wheat allergy is fuzzier. Some websites suggest that 18 million people are sensitive to gluten. Most patients complain of stomach problems and gas. Some add in fatigue, brain fog and depressed mood. There are no confirmed tests for the condition. Many people who say they are gluten sensitive never receive a test for celiac disease, wheat allergy or other sensitivities. They cut out gluten and they feel better. This is often the case for people with irritable bowel syndrome, or IBS, a condition characterized by stomach pain, bloating, gas and diarrhea or constipation.

Also worth noting:

But Reiner Ullrich, an immunologist at Charite University Medicine in Berlin, Germany, says that Gibson lab studies are useful “as pilot studies in need of confirmation. We should consider FODMAP content when examining the gluten-free diet.” But he is also concerned that the studies tested the diets for only a few weeks (at most) at a time. Ullrich would like to see the diets tested for at least eight weeks. “I fear there is no shortcut to establish dietary or drug effect in IBS,” he notes.


“People with IBS are a very heterogeneous population,” he [Peter Green] explains. “It’s a complex issue, and this study adds to the confusion.”

Read the complete article at ScienceNews.org.

(photo: commons.wikimedia)


drwangenIn this week’s Digestive Health Smartbrief, self proclaimed experts on gluten sensitivity are acknowledging that there is a lot more gluten sensitivity than there is celiac disease. That is good news. But…they are still confused…

I (Dr. Stephen Wangen) have been writing about and studying gluten sensitivity for over a decade, however I was not included as an expert on this article. This is just as well, as the experts are also saying other things with which I don’t want to be associated with.

Among other things, they point out that before you diagnose gluten sensitivity that you should first rule out an allergy and auto-immune causes. This makes no sense for two primary reasons.

First, gluten sensitivity, just like celiac disease, is an allergy.

Secondly, gluten can cause auto-immune reactions, not the other way around. Celiac disease itself is an auto-immune reaction. If you did have an auto-immune disease, then you’d want to be looking for the cause, which might be gluten.

Sadly, the medical system is so warped that it often can’t understand the difference between a symptom and a cause.

It’s not the first time, but will it never end?

Excerpt from Digestive Health:

Experts such as Dr. Alessio Fasano, Director of the Mass General Center for Celiac Research and Treatment, estimate an incidence of gluten sensitivity of up to 7 percent of the population. The causes are under study, but hypotheses include intestinal inflammation, changes in the gut microbiota, and high-gluten wheat.


Study Explores Connection Between Early Infections and Increased Risk for Celiac Disease

biomedcentral articleThis is an interesting study, but it’s not looking at the bigger picture.

Celiac disease is not only a genetic issue, it’s a symptom of gluten sensitivity. The children (in this study) are more susceptible to having infections because they have a gluten sensitivity, not the other way around.

If your immune system is busy fighting the food that you eat, then it isn’t properly fighting viruses and bacteria to which you are exposed. This leads to infections.

Eventually the gluten sensitivity created celiac disease (and autoimmune reaction resulting in villous atrophy), and then they were diagnosed with celiac disease. The association between childhood illness and food allergy/sensitivity is real. But the food is the cause of the problem, not the other way around.

We see this same story repeat itself in our clinic on a daily basis. Many patients describe a long history of illnesses. But once we remove the offending foods from their diet it’s like a miracle. They no longer get sick like they used to. And when you stop to think about it, it makes complete sense. There was always a reason that they were more likely to get sick than other people. Now they know why.

See the study in full at biomedcentral.com


One of the goals with this blog is to discuss the vast amount of information available on the web and to help offer some insight into the articles themselves, their accuracy, etc.

This recent study with explores the “Low Gluten Sensitivity Rate” among the population is an example of the difference between helping people and reporting useless facts. 

Excerpt from About.com:

Research presented at this week’s American College of Gastroenterology meeting reported that the incidence of gluten sensitivity is far lower than the 6% to 7% of the population reported by many experts — more in the range of 0.55%, or one in every 200 people. That’s actually the lowest estimate for gluten sensitivity to date, and would make the cadre of gluten sensitivity sufferers only half as large as the group believed to suffer from celiac disease.

Essentially what these doctors accomplished was simply getting another paper published with their name on it, and nothing more. They simply reported that of the people they saw, a few non-celiacs decided to go gluten free. And that is how they defined gluten sensitivity.

They didn’t measure anything other than that. They didn’t look for people who needed to be gluten free. They didn’t do any tests for gluten sensitivity. They didn’t recommend that anyone go gluten free, which means that a lot of the people in this “study” are still suffering from their symptoms, which is a shame.

Frankly, this is a sad excuse for a study. And About.com does a nice job of including another dissenting voice in the article as well.


However, Dr. Alessio Fasano, director of the University of Maryland’s celiac center and a top gluten sensitivity researcher, blasted the study, calling it “extremely biased” and “not informative.”
Dr. Fasano told me that the study is based “simply on what patients report without an active process of diagnosis as outlined by current guidelines,” which would lead the study authors to miss lots of gluten-sensitive people who don’t yet realize they’re gluten-sensitive (akin to how so many celiac disease sufferers remain undiagnosed).