Wheat intolerant? It may not always be celiac disease

A protein called gluten in wheat, oats, barley and rye (European cereal) is known to cause a condition called celiac disease. It is a condition in which gluten damages the intestines and reduces their ability to absorb food. Individuals with this condition can manifest typical or atypical symptoms. They may not even have any symptoms, which is called silent celiacs.

Typical symptoms of celiac disease include diarrhoea, gastrointestinal disturbances like abdominal distension, bloating, burping, reflux, flatulence, pain, constipation, nausea, vomiting, growth problems, stunting, weight loss, anaemia, lethargy or tiredness. However, not everyone shows these symptoms.

Atypical symptoms include bone and joint problems like osteoporosis, arthritis, cramps, aches and easy fractures, skin problems, infertility, recurrent miscarriages, giddiness and behavioural problems like depression, anxiety, irritability and poor school performance. Absence of typical symptoms makes diagnosis difficult and often leads to ill health and life-threatening diseases. Celiac disease can creep up silently on just about anyone, and turn fatal if undiagnosed. Celiac disease is diagnosed through a simple blood test and confirmed through the gold-standard intestinal biopsy, which shows damage to the intestinal lining.

However, another form of sensitivity to wheat is called non-celiac gluten sensitivity (NCGS). The relatively new condition is now being recognised by healthcare practitioners. You may develop it at any age even if you have been consuming gluten all your life.

Non-celiac gluten sensitivity has been coined to describe individuals who cannot tolerate gluten and experience symptoms similar to those with celiac disease. These people lack the same antibodies and exhibit intestinal damage as seen in celiac disease. Research suggests that non-celiac gluten sensitivity is an innate immune response, as opposed to an autoimmune or allergic reaction.

Non-celiac gluten sensitivity has been clinically recognised as less severe than celiac disease. It is not accompanied by enteropathy (intestinal damage), elevations in tissue-transglutaminase (tTg), endomysial or anti-gliadin antibodies, and increased intestinal permeability that are characteristic of celiac disease". Increased intestinal permeability permits toxins, bacteria and undigested food proteins to seep through the gastro-intestinal barrier and into the bloodstream, and research suggests that it is an early biological change that comes before the onset of several autoimmune diseases.

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