New Study Confirms Existence of Non-Celiac Gluten Sensitivity

Though gluten-free diets have been gaining popularity over the past decade, in recent years there’s been a major backlash against anyone who adopts the diet without a diagnosis of celiac disease.

While reasonable people agree that the one in 133 people who suffer from the autoimmune condition should have access to the gluten-free food they need to stay healthy, confusion about whether gluten sensitivity is a real condition has made it difficult for many to receive an accurate diagnosis or to take steps to protect their health.

Now, a major study from Columbia University Medical Center has made a huge breakthrough: researchers have confirmed that NCGS is a real condition that can be diagnosed with a blood test. This will come as a relief to millions of people around the world who have often been accused of “making up” their condition, sometimes even by doctors and medical researchers.

Study Confirms Existence of NCGS and Identifies Key Differences from Celiac Disease

In the past, the only way to be diagnosed with Non-Celiac Gluten Sensitivity (NCGS) was through a process of elimination. Essentially, if someone had the typical digestive symptoms often associated with celiac disease but negative test results for the condition, they might be put on a gluten-free diet anyway to see if their symptoms improved. If the new diet was helpful, they might then be diagnosed with NCGS. It’s a nebulous diagnosis that relies largely on self-reporting, making it problematic to research or treat.

The new study, published in the peer-reviewed journal “Gut”, involved 80 participants with medical histories consistent with NCGS, 40 with diagnosed celiac disease, and 40 healthy participants with no history of gluten or wheat sensitivity. While the study wasn’t able to identify a clear cause of the condition, it did firmly establish, for the first time, a biological basis for the symptoms NCGS patients reported.

In celiac patients, the reaction to the gluten molecule occurs in the small intestine. In healthy people gluten passes harmlessly through the digestive system, but in people with celiac the body mistakenly mounts an immune response against the proteins found in wheat, causing extensive damage to the intestinal lining. People with suspected celiac are screened using a blood test that looks for anti-gluten antibodies. The disease is then diagnosed with an intestinal biopsy showing this damage. However, celiac patients do not have an associated spike in their blood markers indicating high immune activity.

This is where NCGS patients differ. While these patients don’t show the same kind of damage when they’re given a biopsy, their blood panels tell a completely different story. This group showed a spike in blood markers associated with intestinal damage unlike anything seen in the celiac or control group. They also showed a systemic immune reaction after consuming wheat, which is a major difference from the more limited immune reaction of celiac patients.

It’s believed that this widespread immune response is caused by bacteria entering the body through the weakened intestinal lining. In celiac patients, the autoimmune response in the gut destroys these bacteria as well as the body’s own cells. Needless to say, this is an extremely mixed blessing.

Though the cause of the two conditions seems to be very different, the study confirmed that the best treatment is the same for both conditions. After six months of only consuming gluten-free grains, the NCGS group reported a significant improvement in their digestive and non-digestive symptoms, and the immune system markers identified earlier in the study had normalized.

How Does This Fit With Previous Studies Debunking the Existence of Gluten Intolerance?

Unless you’ve been living under a rock for the past few years, you probably remember the headlines from the summer of 2014. A study from Monash University had come out questioning whether Non-Celiac Gluten Sensitivity was actually caused by gluten, or if some unidentified carbohydrate in wheat might be responsible for the range of digestive symptoms that diagnosed sufferers reported.

While some news outlets reported this research accurately, such as NPR’s “Sensitive To Gluten? A Carb In Wheat May Be The Real Culprit” and some (including this very site) reported on the study as just one piece of a complicated puzzle with no clear answer, most of the media didn’t take such a nuanced approach. The Huffington Post declared “Gluten Intolerance May Be Completely Fake,” while the supposedly science-based blog io9 implied that gluten sensitivity only existed in sufferers’ heads.

Despite the fact that the results had only been shown in one small-scale study that had yet to be replicated, Business Insider claimed “Researchers Who Provided Key Evidence For Gluten Sensitivity Have Now Thoroughly Shown That It Doesn’t Exist,” betraying a complete misunderstanding of the very nature of medical research and the scope of the actual findings. Even PBS, of all places, published a breathless blog post with a headline all but proclaiming NCGS patients mentally ill.

This explosion of media attention not only missed the point of the study – that these digestive symptoms were, in fact, real, but might be caused by a component of wheat rather than the gluten protein – they also caused widespread confusion about the nature of celiac disease.

As someone who experiences a severe reaction to gluten, I found myself having to explain over and over to well-meaning friends and acquaintances that celiac disease was a well-established diagnosis and that it had not been the subject of this particular study. To many people, the distinction between the two conditions is not entirely clear, and a large number of people walked away from these headlines sincerely believing that gluten free diets were a complete scam with no medical basis.

I’m not the only person who encountered pushback based on the media coverage: writer Emily Ptacek at Bustle even published an essay exploring the harassment she experienced after the study came out.

To those who embraced the findings of the 2014 study, this new research may seem incredibly confusing. However, the Columbia paper actually doesn’t necessarily contradict the results from the previous study. For one thing, it’s still unclear exactly how wheat triggers NCGS, and it’s possible that a different component of the grain is responsible for the immune reaction seen in patients. This is in line with the conclusions of the Monash researchers.

The new study also found that it took about six months of a completely gluten-free diet for symptoms to subside. The Monash study, however, cycled through various diets in a manner of mere weeks, so it’s entirely likely that the subjects simply weren’t given enough time to show improvement on a gluten-free diet.

In order to truly untangle the results of the Monash study and what it means, it might need to be repeated on a much longer timescale. It might also be helpful to run blood tests for the biomarkers identified by Columbia researchers in order to see how many of the subjects are actually suffering from the condition identified in the new study.

What Does This Mean for People with a Gluten or Wheat Sensitivity?

First of all, it gives sufferers of this condition a way to defend themselves against claims that they’re mentally ill, making up their symptoms for attention, or simply suffering from an eating disorder.

In a world where people with serious food allergies often report severe bullying, including having their food tampered with, this is huge. There will likely still be some skeptics out there, but this is major progress for a disease that’s been so misunderstood.

But more importantly, it reveals some important information that doctors need in order to keep their patients healthy. Before this study came out, it was believed that since NCGS patients didn’t show the same devastating intestinal damage seen in celiac patients, that whatever reaction was occurring would not cause permanent damage to the body and did not involve the same risks of developing cancer or other autoimmune conditions.

Much of the accepted wisdom about the condition made it seem acceptable if NCGS sufferers occasionally “cheated” or slipped up. Now that we know the consumption of wheat products causes these patients to develop a full-body immune response, it may be time to revisit that assumption. It’s possible that if these patients continue to consume gluten it could have serious health effects later in life.

Unfortunately, because this condition appears to be so different from celiac disease, potential treatments such as a gluten-neutralizing pill may not be effective for NCGS. Hopefully, with more research, new ways to treat the disease will reveal themselves.

Photo Credit: Thinkstock.

137 comments

Jerome S
Jerome S1 years ago

thanks

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Jim Ven
Jim V1 years ago

thanks for sharing.

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John B
John B1 years ago

Thanks Julie for sharing the study's results and supportive links.

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Chen Boon Fook
Chen Boon Fook2 years ago

Thanks for this information.

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Robert N.
Rob Chloe Sam N2 years ago

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Toni W.
Toni W2 years ago

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Toni W.
Toni W2 years ago

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Philippa P.
Philippa Powers2 years ago

Interesting. Thanks.

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Laurice Gilbert
Laurice Gilbert2 years ago

useful information

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