Gluten and wheat sensitivity: A type of gluten intolerance
In individuals with gluten and wheat sensitivity, the body reacts to gluten or other components in wheat with very unspecific symptoms. However, these individuals do not have coeliac disease or a wheat allergy. Since there are no specific biomarkers for gluten and wheat sensitivity, this type of gluten intolerance is diagnosed by exclusion.
The hypersensitivity to gluten or wheat can occur suddenly and at any age. However, gluten and wheat sensitivity can also be transient and can improve as the result of a gluten free diet.
Symptoms of gluten and wheat sensitivity
The symptoms of gluten and wheat sensitivity are very diverse and manifest themselves in a wide range of ways:
- abdominal pain, also in conjunction with a burning feeling at the inlet of the stomach, nausea and vomiting, flatulence, a feeling of fullness, constipation and diarrhoea
- fatigue, numbness in the arms and legs, muscle cramps and joint pain
- headache, malaise, lack of drive, confusion, light-headedness
- eczema, red or swollen tongue
Many of these symptoms are also typical of other diseases, which is why gluten and wheat sensitivity often goes unrecognised and is not treated.
Diagnosing gluten and wheat sensitivity
The complex diagnosis of gluten and wheat sensitivity requires ruling out coeliac disease and wheat allergy and responding to a gluten free diet.
The lack of a reliable biomarker – in other words, a measurable indicator – for gluten and wheat sensitivity, as well as the unspecific symptoms, mean that the only way to diagnose the disorder is by exclusion. It is particularly important to first unequivocally rule out coeliac disease and wheat allergy. If coeliac disease and wheat allergy have been ruled out, the next step is for the patient to follow a gluten free diet. If the symptoms significantly improve and then worsen as soon as the patient is re-exposed to gluten, the diagnosis of gluten and wheat sensitivity is confirmed.
Treating gluten and wheat sensitivity
The treatment of gluten and wheat sensitivity involves following a gluten free diet.
However, in contrast to coeliac disease, it is not necessary to maintain a gluten free diet as strictly or on a permanent basis. The patient should follow a gluten free diet for at least one or two years. After this period, the patient may begin adding small amounts of gluten to his or her diet. Tolerance to gluten varies widely however, and the addition of gluten must be undertaken very carefully.
Are you a physician or nutritional specialist? You will find more detailed information on gluten and wheat sensitivity at Dr. Schär Institute, the knowledge platform for experts on the topic of gluten intolerance and the gluten free diet.