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Gluten Challenge: Patients with Non-celiac Gluten Sensitivity Report More Symptoms than Those with Celiac Disease

Celiac.com 06/13/2012 - In general, doctors and researchers know a good deal about how celiac disease works, and they are finding out more all the time. However, they know very little about non-celiac gluten sensitivity (NCGS).

Photo: CC -- EmeraldimpIn an effort to learn more about non-celiac gluten sensitivity, a team of researchers recently carried out a study to measure the presence of somatization, personality traits, anxiety, depression, and health-related quality of life in NCGS individuals, and to compare the results with celiac disease patients and healthy control subjects. They also compared the response to gluten challenge between patients with non-celiac gluten sensitivity and those with celiac disease.

The research team included M. Brottveit, P.O. Vandvik, S. Wojniusz, A. Løvik, K.E. Lundin, and B. Boye, of the Department of Gastroenterology at Oslo University Hospital, Ullevål in Oslo, Norway.

In all, the team looked at 22 patients with celiac disease and 31 HLA-DQ2+ NCGS patients without celiac disease. All patients were following a gluten-free diet.

Over a three day period, the team challenged 17 of the celiac disease patients with orally ingested gluten. They then recorded the symptoms reported by those patients. They did the same with a group of 40 healthy control subjects.

The team then had both patients and healthy control subjects complete questionnaires regarding anxiety, depression, neuroticism and lie, hostility and aggression, alexithymia and health locus of control, physical complaints, and health-related quality of life.

Interestingly, patients with non-celiac gluten sensitivity reported more abdominal (p = 0.01) and non-abdominal (p < 0.01) symptoms after the gluten challenge than patients with celiac disease. The increase in symptoms in non-celiac gluten sensitivity patients was not related to personality.

However, the two groups both reported similar responses regarding personality traits, level of somatization, quality of life, anxiety, and depressive symptoms. Responses for both groups were about the same as for healthy controls.

The results showed that patients with non-celiac gluten sensitivity did not show any tendencies toward general somatization, as both celiac disease patients and those with non-celiac gluten sensitivity showed low somatization levels.

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13 Responses:

 
Dr Charles Parker
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said this on
19 Jun 2012 3:22:59 AM PST
Interesting report, coincides with our personal observations in the office. Some with the most pervasive psychological and biomedical challenges show almost no specific bowel symptoms - and we must work hard to chase down the details.

In our work, with hundreds of IgG testing reviews: milk is even more prominent as a primary causality in immune dysregulation than wheat, and eggs join that triad at the top.

 
SandraB
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said this on
20 Jun 2012 4:23:31 AM PST
For us laymen, somatization is "the conversion of mental experiences into bodily symptoms" i.e., the pain in the body is real, but due to mental stress rather than having a physical cause. Known to the cynical as "It's all in the head."
So it's not all in our heads. It's in our guts - which is where and how we knew it was.

 
Laura
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said this on
27 Jul 2012 12:33:30 PM PST
I am very happy to see this article and study! I am new to the gluten-free lifestyle. I was referred to a gastrointestinal doctor who thought my claims of having reactions to gluten other than digestive were crazy. I may be crazy, but I knew I was right!

 
Laura Cunard
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said this on
20 Aug 2012 8:36:29 AM PST
When I wrote out a full history of how gluten affects me, the GI I showed it to looked at me like I was nuts. He knew NOTHING about non-celiac gluten intolerance. I left the office rather depressed and went back to taking care of myself without help from any doctor. I'd sure like to find one nearby that does know something.

 
Leen Coremans
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said this on
03 Oct 2013 5:01:34 AM PST
Your story is an exact copy of what I went through, Laura! Very frustrating indeed. Luckily we were both stubborn enough to do what we felt was right and go GF. But a doctor who believes you would sure feel good, so I'm very happy to read these kinds of studies and am impatiently awaiting the day where NCGS will be just as well-known as celiac itself (and preferably receive a more suitable name).

 
Kate
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said this on
10 Sep 2012 10:25:42 PM PST
Hi Laura,
My doctor also knew nothing about non-celiac gluten intolerance and I have since found out that they are not taught much about food intolerance at med school. I had symptoms for over 20 years and have found that the only person able to help me was, well, me! Dozens of doctors, no advice that was of any help, tired, fed up, unwell every single day all down to a tiny protein. Now if they had only told me that 20 years ago, life would have been so much better. I did, however, find a wonderful dietitian who specializes in food intolerance. That may be your best bet.

 
Patricia
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said this on
24 Sep 2012 8:54:50 AM PST
Having many of the symptoms for celiac disease (including many positive family members) I decided to go gluten-free 4 weeks ago and feel so much better. Of course, after 4 weeks of being gluten-free, my bloodwork came back negative. I'm now on a gluten challenge for one week (doc recommendation) and will have my blood retested. The first night of having gluten I was really sick (in and out of the bathroom for approximately 6 hours). In the next few days, the symptoms seem to be changing, i.e. constipation. Can anyone tell me if this is a direct result of consuming gluten again? I am extemely frustrated with the process. I'm also concerned that the bloodwork will again be negative and therefore be crazy to go back to a gluten-free diet if not necessary. But, am I correct in thinking that all blood tests can be negative and still have a gluten sensitive issue? I have not had the intestinal biopsy and probably should not have it done if all bloodwork is negative, right? ANY help would be appreciated.

 
Denise
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said this on
08 Nov 2012 9:46:15 AM PST
Hey Patricia
I've had chronic constipation for years. My joints and lower back ached regularly, my iron counts were often low, low wbc, low end of B12, bloated, abdominal pain, foul smelling and fatty BM (very small... like almond-sized) and never relieved, gassy, fatigue, and my hair fell out more than normal in the shower. I did have a long list of food and seasonal allergies as a kid... nothing life-threatening, but take Aerius from April to first frost to manage my symptoms. I do get itchy skin and throat/ear canal, and a feeling of water in my ears... like hearing under water. On top of this I am having acid reflux, nausea, and indigestion, with a feeling of a fist in my stomach (which a prescription for Ranitidine is helping magnificently!) All this said...years of these complaints have been fluffed off by my doctor. Every year at the time of my physical I'd complain about these symptoms, and every year he'd put me on iron if blood tests showed low counts, and tell me to drink more water and eat more fiber! What he wasn't listening to is that I DO drink plenty of water, and my diet is VERY high in fruits/veggies and fiber! My mother-in-law calls me the walking Canada food guide!

I was out of work in September when the kids returned to school and I decided to look into things myself. I found an interesting article online that suggested IBS symptoms could be linked to gluten intolerance. My mother-in-law IS celiac, so I am familiar with the diet and the label reading (because I do cook family meals). I always rolled my eyes at her when she suggested I get tested (hubby and kids were tested for celiac disease, but since I'm not in that blood line I didn't bother). After less than a week eating gluten-free, I began having regular bowel movements. After 2 weeks my joint pain was gone, the water in the ear feeling is mainly gone (had a few brief episodes) and pain in stomach gone. Most all of my symptoms are gone or greatly improved... it's been 5.5 weeks now. At 2 weeks gluten-free, I had a doctor's appt. His eyebrows shot up at my reports. He thinks my heartburn problems and my stomach issues may be connected, and I have been referred to a GI and an Alergist. In the meanwhile I had a genetic blood test for celiac disease since at the time of the requisition I'd already been gluten-free for 4 weeks and probably wouldn't show the necessary antibodies. BUT guess what? I got a call this week from the nurse saying I may, in fact, have celiac disease because it showed that my genetic make up supported a probability of Celiac!!! So, now I wait. I am not sure if I would consider going back to wheat in my diet just for a certain diagnosis. If things are working, I don't feel the need to be a "card-carrying Celiac"! I would, though, agree to the biopsies of the esophagus and intestines to rule out any growths or cancer.

Sorry so long-winded. Hope this helps!

 
Holly W
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said this on
04 Mar 2015 8:21:16 AM PST
This sounds like my story...I have fought IBS for YEARS, had 1/3 of my colon removed and still fight skin issues, arthritis and worst of all, such severe digestive issues I often feel as though I can't plan anything in my life for fear I will be "sick" that day! My gastro doc keeps giving more meds and also says drink more water, more fiber (take Metamucil and such which just abound turns me inside out!) I eat very carefully, lean meats and lots of fruit, veggies, fiber...but nothing has helped. I am now determined to try the gluten free with great hope for some relief. Thanks for sharing your information!

 
Bobbi
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said this on
02 Oct 2012 4:18:25 PM PST
By the time my daughter was 19 she was sick and had routinely been seeing specialists for 2 years who thought she might have Lupus, though she tested negative. She is 5'10" and when she finally hit 112 pounds, I said "Thats it!!". I took her to an alternative doctor who diagnosed her as food allergies/sensitivities. She was tested and found to have dairy, eggs, beef, gluten, soy, garlic, and pineapple. Non-Celiac Gluten Sensitivity has already caused so much damage to her GI that she has had 2 surgeries. She eats a very strict diet, which has helped greatly. She is retested annually because your sensitivities can change (which they have). Also... did you know that food sensitivities can cause you to be tired, give you arthritic problems, and skin issues like eczema and rashes? Taking supplements is a must for the rest of your life due to malabsorption and diet.

 
Lapinta59

said this on
06 Oct 2014 11:28:54 AM PST
Neither my spouse nor I have been tested for gluten sensitivity but my spouse has had stomach problems for years: bloating, gas, diarrhea, intestinal distress, etc. The docs always gave him Prilosec and Tums but nothing worked. He has other food allergies to oats, eggs, and red dye. We tried a completely gluten free diet and ALL of his symptoms disappeared. It has been nothing short of a miracle. I found on the GF diet that my joint pain, fatigue, depression, blood sugar issues, and dermatitis disappeared. I had been told by my docs that I had osteoarthritis and had been prescribed massive doses of Ibuprofen....now I can say all that pain is gone, my skin in clear and I am no longer fatigued or depressed. Who new gluten could be so destructive!

 
Heather
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said this on
09 Oct 2014 3:30:45 PM PST
I am a woman who was diagnosed as Gluten Intolerant when I was 62 yrs.old, by having a food sensitivity test. The test also indicated an intolerance to milk products. The Dr. tested me for Celiac but it came back negative, he said I had IBS. I was suffering with this ever since I was very young and never knew why, it was mild at that time. It has been 7 yrs. since finding out why I was constantly ill with severe back pain from my lower back up into my neck, cramps, bloating and diareah that would last for hours and exhaustion that put me to bed unable to function. The symptoms start the day after ingesting wheat products and it always takes at least 3 days for my body to feel some sense of normal. Since that time I have researched for foods,books and any new info. regarding gluten intolerance. I did find a product called Gluten Ease that allowed me to have something with gluten on occassion when I was eating out. It's been a continuous trial and error struggle. I've learned of the damage it can cause the body, but still struggle with the mental aspect. Everything seems to have gluten in it, even in foods a person would never think would have it. No matter where I go there is always someone else that has the same issue or a relative, adult or child, who is newly diagnosed. I'm still trying to discover why it is that it affects a lot of people, but not everyone. Any new info. would be greatly appreciated.

 
Gayle
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said this on
20 Feb 2015 7:52:42 PM PST
Thank you for this article.




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