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A recently published paper in the journal Nutrition in Clinical Practice[1] discussed the results from an Australian group exploring the global trend in self-diagnosis of non-coeliac gluten sensitivity (NCGS). We are all aware that the possibility that gluten and or related compounds may relate with our gastrointestinal tract and associated immune cells in a detrimental manner leading to a wide range of symptoms. Well we are not alone and many people are making the leap to exclude gluten without any formal diagnosis or even careful work up – so what some may say, well the Australian group suggest this may come with unanticipated risks.

Gluten Sensitivity: Real or Not

Wednesday, 19 December 2012 by

…..Is the title to the BMJ’s Editor’s Choice article this week (Dec 12th 2012) and whilst we in the Nutritional Therapy world find the concept that physicians still deny the empirical evidence of people recovering post gluten and often lactose excluding diets as NOT being indicative of there being a problem, Fiona Godlee does recognise a problem exists.[1]

Coeliac disease (CD), also called gluten-sensitive enteropathy or non-tropical sprue, is a unique autoimmune disorder which results from the interaction between gluten and immune, genetic and environmental factors. Originally CD was considered as a malabsorption syndrome of childhood, whereas it is now recognised as a disease which may be diagnosed at any age.

Gluten sensitivity is a new concept to define a condition of some morphological, immunological and functional disorders that withdraw with a gluten free diet in patients with or without HLADQ2/ DQ8 positive, with negative gluten-specific autoantibodies and without histological characteristic of coeliac disease (CD).

There are questions in the literature, at Dr’s Surgeries, in hospitals and in clinics relating to the existence of gluten generated problems including, increased gut permeability and gastrointestinal symptoms in patients that do not diagnostically qualify as being coeliac.

In fact many people will state they are aware that not eating gluten helps them, and aids well -being , and may even resolve quite significant physical distress. They note recovery on a GFD and yet still have problems achieving medical and family support for their activities.

Have you ever suspected that you and bread do not really get on? Do you find the smell, texture and taste delicious but that once eaten you start to feel less well?

You are not alone, literally hundreds of thousands of people in the UK are facing an environmental challenge at almost every meal – WHY – well wheat and other gluten containing grains are ubiquitous in our prepared foods and the numbers of people with an immune reaction to its principle protein –Gluten- are multitudinous.

Examples of macroscopic features of villous atrophy detected by wireless capsule endoscopy in coeliac disease: A) Normal villi, B) scalloping of the mucosa on circular folds, C) fissuring of the mucosa, D) mosaic pattern. © Mayo Clinic

Researchers from the USA, Europe and other research centres are suggesting that Coeliac Disease has increased up to 4 x in the last 30 years.

They suggest that as much as 1% of the adult and child populations may have CD, and as we know there are many others that have yet to have the disease diagnosed, but experience problems with gluten and are diagnosed as being intolerant or sensitive.

Let’s be clear about what gluten intolerance is. ‘It isn’t a food allergy’. It’s a physical condition in your gut. Basically, undigested gluten proteins (prevalent in wheat and other grains) lurk around your intestines and are regarded by your body as a foreign invader, irritating your gut and flattening the essential microvilli along the small intestine wall. This reduces the surface area available to absorb the nutrients from your food. This can result in symptoms of malabsorption, including chronic fatigue, neurological disorders, nutrient deficiencies, anaemia, nausea, skin rashes, depression, and more.

Whilst there are better screening techniques today than there were in the 1980’s, we must also recognise that there are many other factors at work here, one of which is the changing levels of gluten in grains from hybridisation techniques.

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