Can Gluten Cause GI Problems If You're Not Gluten Intolerant?
#363987 - 03/15/11 07:36 AM
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Cyndy
Reged: 03/05/05
Posts: 1301
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Can anyone please explain this study recently published in Heather's newsletter? At first I thought it was saying a gluten containing diet wouldn't make a difference in symptoms. But at the end of the full study, it sounded like a non gluten containing diet would help those who did not have celiac but could be gluten sensitive. Can any scientific minds please help me to understand the study? I would appreciate it. Thank you.
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This is an area of GI research that is poorly understood and frequently called "no man's land of gluten sensitivity". There is some evidence from small clinical IBS studies that show there may be a non-celiac gluten intolerance but there are no clues as to what might be the cause.
One of the best studies to date is the one given in the reference below. It was done by some of the researchers that developed the FODMAP approach (see references in my signature).
There are no tests for non-celiac gluten intolerance other than try a gluten-free diet. However, there is a confounding factor. Some people have difficulty with fructans, a FODMAP, found in wheat which also contains gluten. Sometimes it is useful to first try removing wheat products reducing fructan consumption before trying a full-fledge gluten free diet which is more difficult to follow.
Reference
Biesiekierski, J. R. et al. Gluten Causes Gastrointestinal Symptoms in Subjects Without Celiac Disease: A Double-Blind Randomized Placebo-Controlled Trial. . (2011)
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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Syl,
Did you read the research that was just posted in Heather's newsletter? Can you help me understand what that study is trying to say? 
Thanks for all your explanation and help.
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I couldn't find the newsletter you were talking about. Can you post the link to the newsletter?
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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study
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That is the same study I gave the reference to and discussed in my initial posting  I have read it. Some authors on that study - Shepherd SJ, Muir JG, Gibson PR - we the ones who developed the FODMAP approach for managing symptoms of GI disorders.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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I don't understand what this particular study is saying.
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It is saying a small number of IBS individuals that do not test positive for celiac disease show some self-reported improvement when place on a gluten free diet. No mechanism for the gluten intolerance in these non-celiac individuals is known. Also, they say that there is a confounding factor. Wheat which is high in gluten is also high in fructans which are known to cause GI symptoms. Also, they say "Wheat proteins are commonly implicated in food hypersensitivity and it must be considered that the induction of symptoms by gluten in this study might be a wheat-specific phenomenon, and not gluten specific."
In summary, the study was small but suggested a small number of IBS individuals may see an improvement in symptoms on a gluten free diet even though they don't have celiac disease. However, they have not been able to exclude the possibility that wheat alone not the gluten in it may be the culprit for some. Also, unlike celiac disease there is no evidence for intestinal inflammation or other organic damage.
--------------------
STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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