Nonceliac Gluten Sensitivity (Intolerance)

  • Medical Author:
    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical Editor: Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)
    Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

    Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

    Dr. Anand received MBBS degree from Medical College Amritsar, University of Punjab. He completed his Internal Medicine residency at the Postgraduate Institute of medical Education and Research, Chandigarh, India. He was trained in the field of Gastroenterology and obtained the DPhil degree. Dr. Anand is board-certified in Internal Medicine and Gastroenterology.

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Food allergies or food intolerance

The next question to address is could the symptoms be due to an allergy to foods in the diet other than gluten? Allergic reactions to foods are caused by the proteins they contain. Some of the most common and well-documented food allergies in adults are milk protein, eggs, soy, shellfish, and nuts, particularly peanuts. It is difficult to diagnose food allergy. The standard tests for allergy, including skin and blood tests, are not very precise. The only way to diagnose food allergy is by eliminating the potentially offending food from the diet and observing the response of symptoms. Unfortunately, this puts us back dealing with the placebo effect. Since food allergy is infrequent in adults, it probably is not the explanation for symptoms among patients, even those who think they have gluten sensitivity.

There are examples of food intolerances or sensitivities other than gluten. Probably the most common is milk intolerance, with symptoms arising because of the inability to digest lactose, the sugar in milk. The undigested, unabsorbed lactose reaches the colon where colonic bacteria turn it into gas and chemicals that cause symptoms. Most people who have improved with a gluten-free diet and believe they are gluten-sensitive already have tried eliminating milk and milk-containing foods from their diet. It didn't work. Could there be an intolerance to another food that causes the symptoms? What food could it be?

Medically Reviewed by a Doctor on 5/4/2015

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