ACE Certified Personal Trainer

Dr. Aanchal Mahajan author
M.B.B.S. , M.D. Pharmacology

If you face gastric issues like pain in your abdomen, abdominal discomfort , bloating, diarrhea associated with tiredness or fatigue after consuming wheat, rye and barley, you are not alone.

Three different disorders namely coeliac disease, non-coeliac gluten sensitivity (NCGS) and wheat allergy can cause problems when you eat these foods. And together, these three conditions affect millions of people in India and around the world.

So, how to differentiate between coeliac disease, NCGS and wheat allergy and what should you do if you think you have one of these conditions?

Quick overview –

Coeliac disease – It’s an autoimmune disorder. Eating gluten(protein) can damage your small intestine. Test positive for tTG – IgA antibody.( tissue transglutaminase IgA). It runs in the families.

Non coeliac gluten sensitivity / gluten intolerance/ gluten sensitivity (NCGS)
Tests negative for tTG IgA but reacts badly to gluten and has no association with family history.

Wheat allergy – Immune system over reacts to wheat and it could be life threatening too.

It’s very easy to confuse Coeliac disease or Non Coeliac gluten sensitivity Because they have two things in common:

  • NCGS and celiac disease have nearly identical symptoms.
  • Symptoms get better when you cut gluten from your diet.

So, in Coeliac as well as NCGS eating gluten causes:

  • Bloating, gas and constipation.
  • Brain fog, fatigue and headaches.
  • Depression.
  • Diarrhea and nausea.
  • Joint pain

Coeliac versus NCGS

In Coeliac disease, even small amounts of gluten can damage the lining of the small intestine (bowel), which prevents the proper absorption of food nutrients. So symptoms related to malabsorption like anemia, weight loss and osteoporosis are seen in Coeliac disease while in NCGS these symptoms are uncommon.

In gluten intolerance, there is no cell damage or inflammation. It’s more of a sensitivity. So, on eating gluten you can have an immediate reaction, such as abdominal pain, discomfort or diarrhoea.

Is wheat allergy related to NCGS and Coeliac disease?

A mild wheat allergy may look like Coeliac or NCGS but It’s very important to get a diagnosis — don’t just assume that you have gluten intolerance because allergies happen when the immune system attacks something that’s usually harmless. So in case of wheat allergy even a tiny amount of wheat is life threatening. People with severe allergies react to inhaling or smelling wheat, even if they don’t eat it. This type of reaction won’t happen in NCGS or celiac disease.

Wheat allergic patients can experience

  • Anaphylaxis, a severe, life-threatening reaction that causes swelling and trouble breathing.
  • Headache.
  • Hives or skin rash.
  • Nausea and vomiting.
  • Runny nose congestion or sneezing.
  • Wheezing or asthma attack.

How to know which disease you have?

Diagnosing Coeliac disease

  • Antibody testing – tTG-IgA
  • Biopsy
  • Gene testing

Note- Tests for celiac disease only work if you’ve been eating gluten. If you first eliminate gluten from your diet and then visit health provider then results would not be 100% true

Diagnosing NCGS

No blood test can diagnose NCGS

It requires two things:

  • Negative blood tests for celiac disease.
  • Feeling better when you stop eating gluten.

Diagnosing wheat allergy

  • Blood tests: Immunoglobulin E antibodies (IgE) to wheat protein.
  • Skin-prick test

How are gluten related disorders treated?

Strict lifelong gluten free diet is the treatment.

How to follow a gluten-free diet?

Despite cutting gluten from your diet, you can still enjoy a nutritious, balanced, delicious diet with a wide range of foods.

You can do this by choosing:

  • Naturally gluten-free foods, such as fresh fruits and vegetables, fresh, unprocessed meat and fish, eggs, nuts, seeds, legumes, most dairy foods, fats, oils and alternative grains (such as corn, rice, quinoa, sorghum, buckwheat and soy)
  • Products which are labelled as gluten free.

Avoid gluten containing Foods

Foods which have a gluten containing grain as one of their main ingredients are easier to identify and avoid, such as bread, wheat pasta, porridge, cakes, biscuits, beer etc.

List of some other gluten containing foods

  • Soy sauce
  • Gravies
  • Soups
  • Sauces
  • Dressings
  • Sausages
  • Ice cream
  • Custard powder
  • Baking powder

So, if you have gluten related disorders , be ingredients aware and read the label twice before picking any food.

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