What is Gluten Intolerance?

Gluten intolerance – together with food intolerance as a whole – has become a growing concern in recent years, prompting much discussion as to why it is on the increase. While food production and manufacturing processes are highlighted as possible reasons, increased awareness of intolerances and developments in the testing/diagnostic process may also explain the rise.

Here, Cleveland Clinic Abu Dhabi dietitian, Annelie Shaw explores some of the key questions and common misconceptions surrounding the subject of gluten intolerance:

What is gluten?

Gluten is the term used for the group of proteins found in wheat, rye and barley. Gluten acts as a binding agent, helping foods stay together. It is present in a wide variety of foods, including bread, pasta and cereals; even soups, vinegars and sauces can contain gluten.

What are the symptoms of gluten intolerance?

There can be several symptoms that indicate gluten intolerance, these include:

• Diarrhea
• Constipation
• Nausea/vomiting
• Bloating / gas
• Stomach pain
• Fatigue
• Headaches
• Irritability

If you are intolerant to gluten, you may experience one or a combination of these symptoms after consuming foods with gluten. You may also find the severity of the symptoms changes according to how much gluten you have consumed.

Is gluten intolerance the same as celiac disease?

No, in fact, gluten intolerance is sometimes given the name non-celiac gluten sensitivity (NCGS). While the two conditions can present with similar symptoms, celiac disease is an autoimmune disease. For those with celiac disease, when they consume gluten, their immune system responds by attacking the small intestine, causing damage to its lining and affecting the body’s ability to absorb nutrients.

A blood test can help to confirm or rule out celiac disease, and should be performed even in cases where gluten intolerance is suspected. For celiac sufferers, a completely gluten-free diet is essential.

Does gluten intolerance mean you’re allergic to foods with gluten?

No, being intolerant to a food is not the same as being allergic to it. The body’s response to being intolerant to a particular food, or food group, is different to an allergy.

Food allergies occur when the body’s immune system wrongly thinks that a food protein is harmful and acts against it. Allergic reaction symptoms can also be noticeably different, and can include a rash, chest pain and difficulty breathing; at its most severe, an allergic reaction can be life-threatening.

There are many types of food intolerance, and these do not involve the body’s immune system. Commonly, the body’s digestive system is affected, and this triggers the symptoms mentioned above. However, food intolerances present a vast range of symptoms, individual to each patient.

Is a completely gluten-free diet essential to treating gluten intolerance?

Not necessarily. Some people may have only a mild intolerance to gluten and therefore be able to consume small amounts of foods containing gluten. Even for others with a more severe intolerance, they may, after a period of avoiding gluten, be able to occasionally eat small amounts without provoking symptoms.

Your doctor or dietitian will be able to help you identify how much gluten you can consume before symptoms occur and may ask you to follow a gluten-free diet, and then reintroduce gluten foods to see how your body responds.

If I’m gluten intolerance, which foods should I limit or cut out?

There are quite a number of foods that contain gluten and many of which may surprise you. Most supermarkets now carry gluten-free ranges, so this provides you with a good starting point when food shopping. It’s also important to check the ingredient labels of any foods you purchase to see if they include gluten-containing grains or grain derivatives like spelt.

Common foods that contain gluten:

• Breads
• Cereals
• Crackers
• Pasta
• Baked goods
• Biscuits

Sauces, soups, dressings, seasonings, spices and vinegars may also contain gluten.

Naturally gluten-free foods:

• Fruit and vegetables
• Plain dairy products (milk, natural yoghurts and unprocessed cheese)
• Fresh unprocessed meat, fish and chicken
• Eggs
• Naturally gluten free grains e.g. rice and quinoa
• Potatoes

If you suspect you may be suffering from gluten intolerance, don’t simply switch to a reduced or gluten-free diet, first contact your doctor or nutritionist for proper testing and diagnosis.