How to Diagnose Gluten Problems

Symptoms of gluten sensitivity include irritable bowel type symptoms such as bloating, abdominal pain, and changes in bowel habits, as well as systemic manifestations such as brain fog, headache, fatigue, depression, joint and muscle aches, numbness in the extremities, skin rash, or anemia. I previously discussed why people who suspect they might be gluten sensitive should not go on a gluten-free diet. But if that’s true, what should they do?

The first thing is a formal evaluation for celiac disease, which currently involves blood tests and a small intestinal biopsy. If the evaluation is positive, then a gluten-free diet is necessary. If it’s negative, it’s best to try a healthier diet with more fruits, vegetables, whole grains and beans while avoiding processed junk.

In the past, a gluten-free diet had many benefits over the traditional American diet because it required increasing fruit and vegetable intake—so no wonder people felt better eating gluten-free: no more unhealthy bread products, no more fast food restaurants. Now, there is just as much gluten-free junk out there.

If a healthy diet doesn’t help, then the next step is to try ruling out other causes of chronic gastrointestinal distress. In a study of 84 people who avoid wheat and/or gluten (or, as they’re called in the literature, “PWAWGS”), about a third didn’t appear to have gluten sensitivity at all. Instead, they either had an overgrowth of bacteria in their small intestine, were fructose or lactose intolerant, or had a neuromuscular disorder like gastroparesis or pelvic floor dysfunction. Only if those are also ruled out, would I suggest people suffering from chronic suspicious symptoms try a gluten-free diet. If symptoms improve, stick with it and maybe re-challenge with gluten periodically.

Unlike the treatment for celiac disease, a gluten-free diet for gluten sensitivity is ideal not only to prevent serious complications from an autoimmune reaction, but to resolve symptoms and try to improve a patient’s quality of life. However, a gluten-free diet itself can also reduce quality of life, so it’s a matter of trying to continually strike the balance. For example, gluten-free foods can be expensive, averaging about triple the cost. Most people would benefit from buying an extra bunch of kale or blueberries, instead.

No current data suggests that that general population should maintain a gluten-free lifestyle, but for those with celiac disease, a wheat allergy, or a sensitivity diagnosis, gluten-free diets can be a lifesaver.

Please let me know your thoughts so far of my coverage of the best available science I’ve found. If there are any pieces you think I missed or got wrong, please let me know so I can correct them!

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of DeathMore Than an Apple a Day, and From Table to Able.

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Treating Asthma With Fruits and Vegetables

75 comments

Siyus Copetallus
Siyus Copetallus3 years ago

Thank you for sharing.

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Sarah Hill
Sarah Hill3 years ago

Thanks. I have cut back on gluten.

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Valentina R.
Valentina R3 years ago

Thanks for sharing. Hopefully I will never become gluten intolerant, I adore pasta.

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Nikki Davey
Nikki Davey3 years ago

Tyfs

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Elena Poensgen
Elena Poensgen3 years ago

Thank you

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Caroline d.
Caroline d3 years ago

Thank you.
Blessings

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Caroline d.
Caroline d3 years ago

Thank you.
Blessings

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Caroline d.
Caroline d3 years ago

Thank you.
Blessings

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Caroline d.
Caroline d3 years ago

Thank you for sharing this very interesting article.
Be all blessed as all your loved ones.

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The J.
Vikram S3 years ago

Thanks for sharing.

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