Does #Gluten Sensitivity Exist In The Absence Of #Coeliac Disease?

Whoa, what IS going on at the BMJ? It’s like buses: you see nothing on non-coeliac gluten sensitivity and then two articles come along at the same time! This one, reported beautifully by Dr Briffa, rendered him:

almost speechless at the balanced and honest nature of this account of gluten sensitivity: it recognises the limitations of medical testing and admits there’s things we simply don’t know or understand. I have a feeling there’s going to be plenty of people reading this who will feel inclined to shove these findings in the face of a practitioner who told them their tests were negative and that their wheat sensitivity is imagined and ‘all in their mind’.

Er, yep.

Basically, the researchers reviewed the medical literature to see what evidence they could find of non-coeliac gluten sensitivity existing in the absence of positive coeliac test results. In essence, they found plenty. They were concerned about the growing number of people avoiding gluten to control illness symptoms, which is far greater than the number of coeliacs being diagnosed by the supposed ‘gold standard’ tests:

These patients pose a clinical dilemma to gastroenterologists, general practitioners, and dietitians and in the past have been described as belonging to a “no man’s land” because of the diagnostic uncertainty.

Importantly, the authors concluded:

For patients who report wheat intolerance or gluten sensitivity, exclude coeliac disease… and wheat allergy…. Those patients with negative results should be diagnosed with non-coeliac gluten sensitivity. These patients benefit symptomatically from a gluten-free diet. They should be told that non-coeliac gluten sensitivity is a newly recognised clinical entity for which we do not yet fully understand the natural course or pathophysiology.

Halle-flippin-lujah. TWO calls for recognition in the BMJ. I really am going to have to lie down now before I faint… I actually do feel quite giddy with it.

Read the abstract here. And thank you to all of you who subscribed and got the full text for me. If anyone wants a copy, please do ask.