Non Celiac Gluten (wheat) Sensitivity

There are a group of patients who do not have celiac disease or wheat allergy, but have gastrointestinal and non-intestinal symptoms after consuming foods containing gluten/wheat.

This disease was called non-celiac gluten sensitivity (NCHG) the first years it was defined. However, studies in recent years have shown that gluten is not the only problem causing an immune response; other wheat proteins and carbohydrates also contribute to the ongoing immune response and problem. Thus, it is believed that a more accurate labeling is non-celiac wheat sensitivity; but its widespread use is still in the form of non-celiac gluten sensitivity (NCGS).

NCGS symptoms can be seen throughout the body:
• Classical IBS findings
• Fatigue
• Listlessness
• Headache
• Migraine
• Brain fog
• Depression
• Anxiety
• Sleep disorders
• Fibromyalgia
• Myofascial pain
• Ataxia
• Skin problems, dermatitis
• Joint/ connective tissue inflammation, pain
• Gastro esophageal reflux
• Aphthous stomatitis
• Anemia
• Depression
• Asthma/ bronchial hyperactivity
• Rhinitis
• Conjunctivitis

Some patients have minimal or no gastrointestinal symptoms, but have pronounced extra intestinal findings. NCHG is sometimes considered a ‘neurological disease’ because migraine, fibromyalgia, myofascial pain, forgetfulness, ataxia, polyneuropathy and cognitive disorders are much more prominent than intestinal symptoms.

Although NCGS patients have problems after gluten/wheat ingestion, unlike celiac disease, there is no direct laboratory test for diagnosis. The diagnosis is made by observing the symptoms that reoccur after a gluten rechallenge (consuming gluten again), following a gluten free period. Patients with NCGS symptoms should first be assessed by a gastroenterologist for celiac disease.
Other wheat proteins, such as wheat germ agglutinins and amylase trypsin inhibitors can also activate an immune response in these patients. Immune response and increased intestinal permeability can occur after the ingestion of prolamine and lectin containing grains, pseudo grains (chia and kinoa) and legumes in some patients with NCGS.

More than 50% of patients with NCGS have migraine, chronic headache and chronic pain symptoms. In addition, a significant proportion of patients also have depression and anxiety.

Apart from the immune response and inflammation, vitamin deficiencies due to absorption disorders and intestinal dysbiosis also contribute to disease symptoms. Also, consuming fructanes from wheat can contribute to IBS symptoms in NCGS patients. These small-sized carbohydrates affect the digestive tract and cause intestinal symptoms to appear. They also contribute to fatigue and fibro fog.

A leaky gut causes the protein peptides to enter the bloodstream. Molecular mimicry between food peptides and tissue protein peptides can cause autoimmune diseases.

If you have migraine, fibromyalgia, depression and/or other neurological symptoms, on top of IBS symptoms or any of the NCGS findings, you should definitely be assessed for gluten/wheat sensitivity by your physician.