Triggers for gluten sensitivity

By Jason Clevenger

Summary: A report published by a group of Australian researchers describes how they used the so-called low FODMAP diet to determine if gluten is the only source of symptoms in patients previously diagnosed with gluten sensitivity.

FODMAPs are types of carbohydrates that are known to be poorly absorbed in the small intestine, and a low FODMAP diet has become a recognized treatment for Irritable Bowel Syndrome (IBS).

In the study, 37 gluten sensitivity patients were initially assigned a gluten-free diet with low FODMAPs for two weeks. They were then switched to a high-gluten, low-gluten, or whey (no gluten) diet for a week. While virtually all of the patients exhibited improved gastrointestinal symptoms on the low FODMAP introductory diet compared to their regular gluten-free diet, most experienced worsened symptoms after switching to any of the three diets in the third week.

Conclusion: The authors had anticipated that the gluten-challenge diet would cause specific worsening of symptoms in the high- and low-gluten groups. They were surprised to find that most of the patients in the study exhibited similar gastrointestinal symptoms regardless of gluten intake, including those whose diet in the second phase was gluten free. The authors speculate that since gluten doesn’t appear to be a specific trigger for patients with gluten sensitivity following a low FODMAP diet, gluten sensitivity may not be a separate disease. Instead, it may be a variant of other gastrointestinal diseases.

 

[1] “No Effects of Gluten in Patients with Self-Reported Non-Celiac Gluten Sensitivity Following Dietary Reduction of Low-Fermentable, Poorly-Absorbed, Short-Chain Carbohydrates.”, Biesiekierski JR, Peters SL, Newnham ED, Rosella O, Muir JG, Gibson PR., #Gastroenterology# 2013 May 3 [Epub ahead of print].