While gluten intolerance, also known as celiac disease, is well known, a new condition is gaining ground: non-celiac gluten hypersensitivity. In short, some individuals react to gluten without having a diagnosis of celiac disease. Update on the subject!
Learn to tell the difference
First of all, let’s remember what celiac disease (CD) is. Also called gluten intolerance, this disease requires two conditions to be diagnosed: an intestinal biopsy revealing a mucosal abnormality and the presence of specific antibodies associated with celiac disease. It would affect 1% of the population. People with the condition must follow a strict gluten-free diet for life.
Non-celiac gluten sensitivity (NCGS), on the other hand, is manifested by intestinal symptoms such as diarrhea or constipation, bloating, cramps, as well as so-called extra-intestinal symptoms that include fatigue, rashes, headaches or even depression. People with this condition do not meet both diagnostic criteria for celiac disease. Ingestion of gluten does not cause damage to the intestinal lining.
“It is a condition that is still poorly understood,” reports Christine Desjardins, nutritionist at Cœliaque Quebec. “To date, there is no specific biomarker for NCGS that could help in its diagnosis. The only way to identify it is through an exclusion process: we make sure that the symptoms felt are not caused by celiac disease, a wheat allergy or even irritable bowel syndrome, ”adds the nutritionist. .
Risk factors and prevalence
The risk factors for NCGS are still poorly understood. There is very little evidence on this. Being a non-autoimmune disease, one cannot correlate the disease risk with other autoimmune diseases such as type 1 diabetes or Crohn’s disease. Studies are currently being done to try to find serological markers that would better diagnose hypersensitivity.
According to Cœliaque Quebec and the Canadian Celiac Association, the prevalence is difficult to estimate because many people diagnose themselves without consulting a doctor. However, its prevalence is estimated at 3-6% of the population.
Knowing that celiac disease can increase the risk of other autoimmune diseases and that, if left untreated, it can increase the risk of developing nutritional deficiencies, it is considered to be more dangerous than NCGS.
Currently, research does not show that NCBS can cause medium / long term complications. The quality of life can be seriously affected, however, due to the presence of bothersome symptoms.
On the other hand, we must be careful in the self-diagnosis, a person may believe that he suffers from hypersensitivity, while he is suffering from celiac disease. A late diagnosis of CD can lead to infertility, osteoporosis, anemia, or even bowel cancer. It is therefore important to consult a specialist in case of doubt regarding gluten and to proceed to a screening for celiac disease.
Make the correct diagnosis
In the event of digestive symptoms such as bloating, diarrhea, constipation or cramps following the ingestion of gluten, it is important to consult a health professional in order to rule out any illness that presents similar symptoms. We will therefore try to eliminate celiac disease, wheat allergy or irritable bowel syndrome (IBS). In the case of IBS, for example, it is the reaction to fructans in wheat (fermentable sugars) and not to gluten that causes gastrointestinal symptoms. It is important to consult a doctor before excluding gluten from your diet. Starting a gluten-free diet prior to diagnosis may promote healing of the intestinal lining, which would affect the results of the screening test.
Once the diagnosis of NCGS is established, it is advisable to follow the recommendations of an expert nutritionist to guide the patient to a personalized gluten-free diet since gluten tolerance can vary from person to person. other. In addition, NCMS can be transient just as it can be permanent, hence the importance of rigorous monitoring.
- Cœliaque Québec: For 35 years, Coeliaque Québec has supported people with celiac disease and those suffering from other gluten sensitivities in their new dietary reality. www.fqmc.org
- Professional Order of Dietitians of Quebec. www.opdq.org 514 393-3733
♦ Thanks to Fatima-Zahra Mesnaoui, nutrition intern, for her precious collaboration.
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