Imagine not being able to enjoy pizza, cake, beer or pasta, simply because your body has a reaction to ingesting the gluten contained in those common foods. The Center for Celiac Research & Treatment estimates that 18 million Americans suffer from gluten sensitivity, most of whom are unaware that they even have a condition.
"Between 'normal' and a full-blown gluten rejection in the body (known as celiac disease), there is an emerging middle ground of patients whom we can't diagnose," explains Dr. Rabin Rahmani, a gastroenterologist and celiac expert at Maimonides Medical Center. "These patients have many of the more minor symptoms associated with celiac disease, without actually having the disease." This gray area was first described in detail in 2009 by the American Journal of Gastroenterology as the "No Man's Land" of gluten sensitivity. In 2011, a panel of celiac experts settled on a medical term for the condition: non-celiac gluten sensitivity, also known as NCGS.
Gluten is found in wheat, barley, rye and, possibly, oats. "When people with this sensitivity avoid gluten, they may see their health improve, only to worsen again when gluten is consumed," says Dr. Rahmani. As such, many people with gluten sensitivity are cutting gluten out of their diets to find relief from symptoms such as abdominal pain, diarrhea, cramping, bloating and constipation. Other warning signs include anemia and osteoporosis, which can be diagnosed by your doctor. People who have allergies such as hay fever, as well as allergies to medications, may also be more prone to gluten sensitivity.
Unfortunately, the current research isn’t conclusive. “The question remains whether patients are getting better because of a placebo effect or if it is, in fact, the gluten," explains Dr. Rahmani. Many family members of celiac patients also claim to suffer from gluten sensitivity, which could be due to their heightened awareness of the symptoms or due to a genetic component.
Although the symptoms are similar, gluten sensitivity is less severe than celiac disease. Research shows that gluten sensitivity does not cause intestinal inflammation or lead to the long-term intestinal damage which celiac disease can cause when left untreated. There are currently no specific tests to determine gluten sensitivity, but researchers are working on definitive blood tests for the condition.
"Even if a person suffers solely from gluten sensitivity, there’s a chance it may progress to celiac disease." A strict, lifelong, gluten-free diet is the current treatment recommendation to not only alleviate the symptoms, but also decrease the likelihood of progression to celiac disease.
"Gluten has other manifestations and causes other symptoms with which we may not be familiar yet. The important thing is that there's awareness of the issue." If you find that you’re experiencing symptoms after eating bread, pasta, cake or other gluten-containing foods, make an appointment to consult with Dr. Rahmani by calling (718) 368-2960.
Dr. Rabin Rahmani
Director, Medical Education & Research
Dr. Rahmani is nationally recognized for his cutting edge research in the field of gastroenterology, and has garnered wide popularity in the Brooklyn community for his thorough and compassionate patient care. He subscribes to a "whole body" philosophy to digestive health with a specialty in advanced minimally invasive procedures.
To make an appointment, call (718) 368-2960.
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