Some people can be wheat sensitive without having celiac disease or a wheat allergy. And gluten may not be to blame. When Kathy Pothier began eating gluten-free in 2012, some friends thought it was an inconvenience. So Pothier -- determined to see if the diet could relieve her painful arthritis symptoms, stiff neck, and headaches -- took her own food when she visited for dinner.
Because the 47-year-old landscaper from Amesbury, MA, doesn't have celiac disease or wheat allergy, her friends dismissed her diet as the latest fad. But Pothier says that going gluten-free gave her relief from her pain. "When I stopped [gluten], it all went away within 3 months," she says. Emerging research is suggesting that some people without a diagnosis of either celiac disease or wheat allergy may indeed be wheat-sensitive -- and the gluten may not be what’s causing their problems. They may have bloating, pain, gas, and diarrhea that are hallmark symptoms of celiac disease. Or they may also have headaches and inflammatory symptoms like Pothier’s. “I think there is now enough data to say that there are people out there who do have symptoms that are related to either wheat or gluten who are not [diagnosed with] celiac and not classic wheat allergy," says Joseph Murray, MD, a professor of medicine and gastroenterology at Mayo Clinic, Rochester, MN. "It's probably relatively rare," he says, pegging it at about 1% of the population, or about 3 million people in the U.S. Celiac is diagnosed with a blood test or intestinal biopsy; wheat allergies are diagnosed with a skin or blood test. Until about 5 years ago, if people were not diagnosed with either, they were told they had no reason to be on a gluten-free diet, says Alessio Fasano, MD, director of the Center for Celiac Research and Treatment at Massachusetts General Hospital. Since then, he says, study after study has found evidence that non-celiac gluten sensitivity may, indeed, be real. "People have dismissed non-celiac gluten sensitivity as a fad," says William F. Balistreri, MD, a doctor at the Cincinnati Children's Hospital Medical Center. "But there may well be an immunologic basis" for it, he says. And the protein gluten may not be the whole story, Murray and others say. Some people could be reacting to other components in the wheat. "Wheat is a very complicated organism," Murray says. Experts now say there may be several subgroups of people with wheat sensitivity, each reacting to a different part of the wheat. Wheat and Health: What's Under StudyAmong the recent studies:
In one, Murray and his colleagues tested the diet on people who had irritable bowel syndrome with diarrhea. "We found that a group of them got better," he says. About half of those on the gluten-free diet had genes linked to celiac disease but were not diagnosed with celiac; those were the patients who got better. He suspects they may have a mild immune reaction similar to that seen in celiac disease. Advice for the Wheat-SensitiveAnyone who thinks they have a problem with wheat should first get tested for celiac disease, Murray says. If they try to cut down or eliminate gluten before getting the blood test, it may produce false negative results. If you test negative for celiac and no one can identify an alternative cause, such as wheat allergy, for your symptoms, ''it might be realistic to go on a gluten-free diet," Murray says. However, he says, ''you must be open-minded to failure. If it doesn't work after 2 weeks, or 4 for sure, it's not going to work.” There is no test yet to determine what element in wheat that people are sensitive to. But those tests are in the works. Fasano is working on a test for people who react to the wheat protein ATIs. Experts predict that in the future, it may be possible to pinpoint which part of the wheat is triggering a reaction, so people can learn what foods to avoid to stay symptom-free. SOURCE: http://www.webmd.com/digestive-disorders/celiac-disease/news/20161123/experts-wheat-sensitivity-is-real#3
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