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Non-celiac gluten sensitivity is real

Researchers have found that even small amounts of gluten can aggravate intestinal and neurological symptoms in people without celiac disease or wheat allergy.

In the study, 61 participants were randomly assigned to groups given either 4.375 g/day gluten or rice starch (placebo) for one week, each via gastro-soluble capsules.1

Intake of gluten significantly increased overall symptoms compared with placebo. Abdominal bloating and pain, among the intestinal symptoms, and foggy mind, depression, and aphthous stomatitis, among the extra-intestinal symptoms, were significantly more severe when subjects received gluten than placebo.

Gluten sensitivity in ME and CFS

Although there has been no direct research into gluten sensitivity in ME or CFS, accumulating evidence suggests that the gluten-mediated immune response is frequently associated with neurological and psychiatric symptoms.2

Non-celiac gluten sensitivity is commonly regarded as a co-morbid condition of ME and CFS, rather than a cause. There are anecdotal accounts of improvements in symptoms after going on a gluten-free diet.3

PHOTO: Wheat fields by Kevin Jaako

Abstract

Small Amounts of Gluten in Subjects with Suspected Nonceliac Gluten Sensitivity: a Randomized, Double-Blind, Placebo-Controlled, Cross-Over Trial.

Di Sabatino A, Volta U, Salvatore C, Biancheri P1, Caio G, De Giorgio R, Di Stefano M1, Corazza GR.

Clin Gastroenterol Hepatol. 2015 Feb 19. pii: S1542-3565(15)00153-6. doi: 10.1016/j.cgh.2015.01.029. [Epub ahead of print], [PubMed]

BACKGROUND & AIMS: There is debate over the existence of nonceliac gluten sensitivity (NCGS) -intestinal and extra-intestinal symptoms in response to ingestion of gluten-containing foods by people without celiac disease or wheat allergy. We performed a randomized, double-blind, placebo-controlled, cross-over trial to determine the effects of administration of low doses of gluten to subjects with suspected NCGS.

METHODS: We enrolled 61 adults without celiac disease or wheat allergy who believe ingestion of gluten-containing food to be the cause of their intestinal and extra-intestinal symptoms. Participants were randomly assigned to groups given either 4.375 g/day gluten or rice starch (placebo) for 1 week, each via gastro-soluble capsules. After a 1 week of gluten-free diet, participants crossed over to the other group. The primary outcome was the change in overall (intestinal and extra-intestinal) symptoms, determined by established scoring systems, between gluten and placebo intake. A secondary outcome was the change in individual symptom scores between gluten vs placebo.

RESULTS: According to the per-protocol analysis of data from the 59 patients who completed the trial, intake of gluten significantly increased overall symptoms compared with placebo (P=.034). Abdominal bloating (P=.040) and pain (P=.047), among the intestinal symptoms, and foggy mind (P=.019), depression (P=.020), and aphthous stomatitis (P=.025), among the extra-intestinal symptoms, were significantly more severe when subjects received gluten than placebo.

CONCLUSIONS: In a cross-over trial of subjects with suspected NCGS, the severity of overall symptoms increased significantly during 1 week of intake of small amounts of gluten, compared with placebo. Clinical trial no: ISRCTN72857280.

References

  1. Di Sabatino A, Volta U, Salvatore C, Biancheri P, Caio G, De Giorgio R, Di Stefano M, Corazza GR., (2015) Small Amounts of Gluten in Subjects with Suspected Nonceliac Gluten Sensitivity: a Randomized, Double-Blind, Placebo-Controlled, Cross-Over Trial. Clin Gastroenterol Hepatol. 2015 Feb 19. pii: S1542-3565(15)00153-6. doi: 10.1016/j.cgh.2015.01.029. [PubMed]
  2. Jackson, J. R., Eaton, W. W., Cascella, N. G., Fasano, A., & Kelly, D. L. (2012). Neurologic and Psychiatric Manifestations of Celiac Disease and Gluten Sensitivity. The Psychiatric Quarterly, 83(1), 91–102. doi:10.1007/s11126-011-9186-y [PubMed]
  3. Gluten: worth avoiding? Phoenix Rising. 2012. [forum]
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Written by Russell Logan

Russell Logan worked as a magazine publisher and editor until forced into early retirement through ill health with ME. He has battled with moderate to severe ME for 25 years. He now lives in Noosaville, Australia.

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