If you’re looking to understand Non-Coeliac Gluten Sensitivity, you’re in the right place.
This article will provide a comprehensive understanding of non-coeliac gluten sensitivity and will be especially helpful if you’re new to gluten-free living or seeking to deepen your knowledge of this new and evolving medical term.
Non-Coeliac Gluten Sensitivity (NCGS) is the term now being used to describe symptoms associated with eating gluten, but where coeliac disease and wheat allergy have been ruled out.
Read on to find out more about NCGS and it’s similarities and differences to Coeliac Disease and other gastrointestinal conditions.
You can also check out The Gut Be Good Podcast & YouTube channel here.
See the content list below for quick links to relevant sections:
Introduction
What is Non-Coeliac Gluten Sensitivity (NCGS)?
How do we recognise and diagnose NCGS?
FODMAPS & Non-Coeliac Gluten Sensitivity
IBS & Non-Coeliac Gluten Sensitivity
Changes in medical terminology – what is NCGS inclusive of?
What does the future look like for NCGS diagnosis?
How does diagnosing NCGS work compared to diagnosing Coeliac Disease?
How to navigate the diagnostic journey of NCGS
Empowering yourself to manage the diagnosing journey of NCGS
Ready to embark on your gut health journey?
Final message
Disclaimers/Disclosures
Sources
Introduction:
Let’s kick off todays post by clearly defining non-coeliac gluten sensitivity. There’s significant misunderstanding around this relatively new term, and it’s crucial to grasp its inclusivity.
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Non-Coeliac Gluten Sensitivity (NCGS)
NCGS is a condition characterized by the occurrence of intestinal and extra-intestinal symptoms after gluten consumption. Importantly, it lacks the autoimmune response seen in coeliac disease and does not involve a wheat allergy.
Symptoms in NCGS closely resemble those of coeliac disease, as discussed in the podcast and in my other recent article called “what is coeliac disease?”. While coeliac disease is a lifelong autoimmune condition leading to intestinal damage, NCGS is not autoimmune. However, both conditions share the same treatment—adopting a gluten-free diet.
- Symptoms Resemblance
- Similarities to coeliac disease symptoms
- Distinctive feature: Not autoimmune
- Not inclusive of wheat allergy
- No biomarkers for testing
- Similarities to coeliac disease symptoms
The Recognition Challenge
Currently, NCGS faces a lack of deserved recognition, with conflicting studies on its exact cause. Diagnosis is challenging due to the absence of specific tests or biomarkers.
Typically, it involves a process of elimination, ruling out coeliac disease, wheat allergy, and sometimes irritable bowel syndrome (IBS).
Diagnosing NCGS is further complicated by varying opinions within the medical community about the root cause of symptoms. Some argue that the term is too specific, leading to alternatives like non-coeliac wheat sensitivity.
This shift is influenced by emerging studies suggesting FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) might be responsible for symptoms attributed to gluten.
If you want to know which dairy foods contain gluten, check out this helpful article of mine. It might help ease some of your symptoms if you’ve been choosing dairy products so far which are not gluten free.
Diagnostic Complications
- Lack of specific tests and biomarkers
- Process of elimination
- Contrasting medical opinions
FODMAPs and NCGS
FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) might be responsible for symptoms attributed to gluten.
FODMAPs and NCGS: FODMAPs are short-chain carbohydrates not fully digested by the body, found in gluten-containing foods.
Their fermentation by gut bacteria produces gas and attracts water, potentially causing discomfort and bloating.
Decoding FODMAPs
- Short-chain carbohydrates
- Fermentation process
- Gas and water production
NCGS vs. IBS
NCGS bears similarity to Irritable Bowel Syndrome (IBS), but they are distinct conditions. Both lack specific diagnostic tests, relying on symptom presentation and a process of elimination.
Symptoms Overlap
- Fatigue, headaches, stomach pains, bloating
- Joint and muscle pains, foggy mind
- Dermatitis, anxiety, depression, anaemia
A shift in medical terminology
The terms “gluten sensitivity” or “gluten intolerance” are now encompassed by NCGS, streamlining the diagnosis of gluten-related conditions in the absence of coeliac disease and wheat allergy.
Use the content list to skip to relevant sections:
Introduction
What is Non-Coeliac Gluten Sensitivity (NCGS)?
How do we recognise and diagnose NCGS?
FODMAPS & Non-Coeliac Gluten Sensitivity
IBS & Non-Coeliac Gluten Sensitivity
Changes in medical terminology – what is NCGS inclusive of?
What does the future look like for NCGS diagnosis?
How does diagnosing NCGS work compared to diagnosing Coeliac Disease?
How to navigate the diagnostic journey of NCGS
Empowering yourself to manage the diagnosing journey of NCGS
Ready to embark on your gut health journey?
Final message
Sources
What does the future look like for NCGS diagnosis?
While NCGS is presumed to be prevalent, challenges in effective diagnosis may lead to self-diagnosis, possibly overestimating its prevalence. Future advancements in medical diagnostics are anticipated to refine NCGS identification and determine its precise cause, be it gluten or FODMAPs.
In the upcoming years, the medical industry’s efforts to accurately diagnose and understand NCGS will likely shed light on whether it should be recognized as a distinct condition, eliminating confusion and ambiguity.
Path Ahead
- Accurate diagnosis
- Distinct condition recognition
- NICE recommendations and pathway for diagnosing
- Further research to establish root cause
Grey Areas and Misdiagnoses
The similarities between IBS, NCGS, and CD often lead to misdiagnoses. Let’s explore this gray area further, discussing the commonalities and distinctions between coeliac disease and non-coeliac gluten sensitivity.
Symptoms overlap significantly, encompassing fatigue, headaches, stomach pains, bloating, joint and muscle pains, foggy mind, dermatitis, anxiety, depression, and anaemia.
The crucial disparity lies in coeliac disease being a lifelong autoimmune condition causing intestinal damage, requiring a lifelong gluten-free diet.
In contrast, NCGS, despite similar symptoms, is not autoimmune, and currently, it’s understood that it doesn’t lead to intestinal damage. This differentiation is pivotal.
Symptom Similarities
- Bloating, foggy mind, dermatitis
- Joint and muscle pains, anxiety, depression
- Crucial Disparity
How does diagnosing NCGS work compared to diagnosing Coeliac Disease?
When it comes to diagnosing coeliac disease or non-coeliac gluten sensitivity (NCGS), medical professionals typically conduct blood tests to identify specific biomarkers associated with coeliac disease. Simultaneously, they often check for the presence of wheat allergy.
In contrast, diagnosing NCGS is more challenging due to the absence of specific biomarkers for testing. Generally, NCGS diagnoses stem from negative test results for coeliac disease and wheat allergy.
The National Institute for Health and Care Excellence currently lacks specific guidelines on the diagnostic process for NCGS, adding an additional layer of complexity to the diagnosis.
Despite the absence of strict guidelines, some general recommendations can assist in determining the potential presence of NCGS.
This involves following a gluten-containing diet for at least six weeks, followed by a period of adhering to a gluten-free diet while monitoring symptoms and reactions to food.
The common assumption is that if an individual, suspected of having NCGS, does not experience improvements in symptoms and overall well-being after six weeks on a gluten-free diet, NCGS may be less likely as the cause.
In such cases, further investigation is warranted to explore the possibility of other gastrointestinal issues like small bowel bacterial overgrowth, irritable bowel syndrome (IBS), or similar conditions.
Diagnostic Approaches
- Blood tests for coeliac disease
- Wheat allergy checks
NCGS Diagnostic Challenges
Diagnosing NCGS is more challenging due to the absence of specific biomarkers for testing.
Diagnosis Complexities
- Lack of specific guidelines
- Process of elimination
- Gluten-containing diet trial
Conclusion:
How to Navigate the Diagnostic Journey of NCGS
In dealing with symptoms that suggest Non-Coeliac Gluten Sensitivity (NCGS) or Coeliac Disease, obtaining sufficient support and assistance is crucial for an accurate diagnosis. Given the current lack of comprehensive knowledge and research on NCGS, the diagnostic journey may encounter various challenges. Nevertheless, symptoms indicative of either CD or NCGS should not be dismissed.
Empowering yourself with Knowledge
It is essential to empower yourself with available knowledge, including the insights provided in this podcast episode.
Take this information to your medical professional for an informed discussion about your unique symptoms and the potential presence of an underlying condition. Seeking professional guidance is paramount in navigating the complexities of diagnosis and ensuring the appropriate steps toward better health.
If you’ve started your gluten free journey, you’ll find my A-Z of gluten free foods article plus what to avoid very helpful to get you going, which you can find here.
I also have a Q&A style post about understanding gluten free living overall, which you will no doubt find helpful after reading this article too.
Use the content list to skip to relevant sections:
Introduction
What is Non-Coeliac Gluten Sensitivity (NCGS)?
How do we recognise and diagnose NCGS?
FODMAPS & Non-Coeliac Gluten Sensitivity
IBS & Non-Coeliac Gluten Sensitivity
Changes in medical terminology – what is NCGS inclusive of?
What does the future look like for NCGS diagnosis?
How does diagnosing NCGS work compared to diagnosing Coeliac Disease?
How to navigate the diagnostic journey of NCGS
Empowering yourself to manage the diagnosing journey of NCGS
Final message
Sources
Ready to embark on your gut health journey?
Join my email list for exclusive insights, subscribe to the Gut Be Good Podcast, and follow The Gut Be Good YouTube channel for more in-depth discussions and helpful (but also, fun) videos!
Keywords: Gut health, Gluten-free living, Podcast, YouTube, Email list, Subscribe, Gluten sensitivity, Gluten intolerance
Final message:
Remember, empowering yourself with knowledge and seeking professional guidance are paramount in navigating the complexities of diagnosis and ensuring the appropriate steps toward better health.
Remember, I’m always here to help!
Get in contact here if you need me.
Gemma x
DISCLAIMERS & DISCLOSURES
This post may contain affiliate links, which means I may receive a commission, at no extra cost to you, if you make a purchase through a link.
Please see my full disclosure for further information – DISCLOSURE
& my full Disclaimer for further information – DISCLAIMER
Any advice offered within this article is meant for educational purposes only and should not be used as a sole resource for understanding the medical conditions discussed within. Any changes made to your diet, lifestyle and general well-being should be discussed with your GP or similar healthcare professional who is aware of your unique medical history and not made according to advice provided within this article or anywhere else on this website.
While the utmost care has been taken in devising the information residing on this website, it is your sole responsibility as the reader to utilise the information as you see fit and by reading the information present on this website you accept personal responsibility over any health outcomes related to you and your condition which occur as a direct or indirect result of using the information on this website in any way.
Always Check Ingredients Labels for Allergen Information before consuming a product.
This is important in case there are changes in manufacturing since the date of publication of this article.
It’s also a good idea in general, especially if you have allergies rather than intolerances/sensitivities to certain ingredients to check ingredients labels before consuming a product.
Sources:
Barbaro MR, Cremon C, Stanghellini V, Barbara G. Recent advances in understanding non-celiac gluten sensitivity. F1000Res. 2018;7:F1000 Faculty Rev-1631. Published 2018 Oct 11. doi:10.12688/f1000research.15849.1
Catassi C, Elli L, Bonaz B, et al. Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts’ Criteria. Nutrients. 2015;7(6):4966-4977. Published 2015 Jun 18. doi:10.3390/nu7064966
Cleveland Clinic. (n.d.). Irritable Bowel Syndrome (IBS). Retrieved from https://my.clevelandclinic.org/health/diseases/4342-irritable-bowel-syndrome-ibs
Monash University. (n.d.). About FODMAP and IBS. Monash FODMAP. https://www.monashfodmap.com/about-fodmap-and-ibs/
National Institute for Health and Care Excellence (NICE). (n.d.). Coeliac Disease – Diagnosis: Differential Diagnosis. Retrieved from https://cks.nice.org.uk/topics/coeliac-disease/diagnosis/differential-diagnosis/
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Gemma