There is considerable debate regarding gluten allergy. Somewhat recently a new clinical entity called non-celiac gluten sensitivity (NCGS) has emerged. These are people who feel better off gluten but are not diagnosed with celiac. Some have called NCGS a fad or not proven, however a recent placebo control trial suggests otherwise.
Dr. Michael Ruscio, DC: Hi, this is Dr. Ruscio, and a recent placebo-controlled trial was published, looking at the relationship between IBS and what’s called Non-Celiac Gluten Sensitivity. Non-Celiac Gluten Sensitivity is a new entity that’s being identified and examined. It’s essentially people that don’t have a full-blown gluten allergy like celiac, but they have a more subtle case of a sensitivity. So, it’s termed “Non-Celiac Gluten Sensitivity”. There’s quite a bit of debate as to whether or not this legitimate or just something that’s just an artifact of the gluten-free fad. Some people want to dismiss the concept of any intolerances to gluten because they are suspicious that it’s probably just a gluten-free fad. This study, however, really showed that Non-Celiac Gluten Sensitivity is somewhat legitimate and it may be very legitimate in causing the symptoms of IBS (or Irritable Bowel Syndrome) which can consist of altered bowel habits: constipation, loose stool and diarrhea, maybe a combination of the two. It may also include abdominal pain, gas, bloating, or flatulence.
DrMR: What this study did was took 72 people and had them go on a gluten-free diet for six weeks, and then observed the level of improvement that the subjects obtained from that gluten-free diet. Then, and this is the important part, half the subjects were given a powder containing gluten, and the other half were given a placebo powder that contained no gluten. Then, the researchers tracked if the improvements were maintained in both groups or if there was regression. Now, here’s where it gets interesting: in the group that received the gluten, only 25% of those people maintained the improvement from the initial gluten-free diet. In the group that received the placebo (or no gluten), 83% maintained their improvement.
“Digestive symptoms that are consistent with IBS may be caused by Non-Celiac Gluten Sensitivity.”
So what we see here is a group of people that go on a gluten-free diet, see improvements in their IBS, the patients that are taking gluten again but are unaware of it, 75% of them have a regression, or a worsening of their symptoms. Whereas if you are not receiving gluten, or are gluten-free still, 83% of those people maintained their improvements.
This certainly legitimizes the concept that digestive symptoms that are consistent with IBS may be caused by Non-Celiac Gluten Sensitivity. What do you do with this information? my recommendation is to look at this in a three-step process: If you or someone you know has IBS, the first thing I’d recommend you do is change your diet. Try gluten-free, and along with gluten-free, I would try an overall healthy diet, something like the paleo diet or the autoimmune paleo diet is a great place to start. If that resolves your problem, great! You’re pretty much done. If it only yields partial results, or no results at all, you may want to try some digestive enzyme supports and a probiotic. See if fooling around with those is able to elucidate improvement for you. If neither one of those does, there’s a good likelihood that you may have an underlying gut problem, like a gut infection, something like candida or SIBO (Small Intestinal Bacterial Overgrowth), and you should get yourself to a skilled clinician to have those investigated and treated.
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