Reviewed by William Blahd on November 16, 2015
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Dr. William F. Balistreri: We now understand that this disorder may affect one percent of the population, over two million individuals in the United States alone.
Dr. William F. Balistreri: This has led to a proliferation of gluten-free products with sales estimated to be over six billion dollars per year. However, many individuals adhere to a gluten-free diet not because they have celiac disease but because they believe they are sensitive to gluten.
Dr. William F. Balistreri: In fact, experts have coined the term non-celiac gluten sensitivity. For those individuals who suffer irritable bowel syndrome or IBS. Symptoms that are relieved by a gluten-free diet. Their symptoms return if gluten is ingested.
Dr. William F. Balistreri: It's unclear how common this disorder may be. However, estimates are that six to seven percent of adults in the United States have non-celiac gluten sensitivity.
Dr. William F. Balistreri: It's also unclear as to the mechanism and whether the restriction of gluten truly alters the natural history.
Dr. William F. Balistreri: There are, however, a few recent studies which suggest that indeed a gluten-free diet can relieve symptoms of IBS. The first was a double blind study conducted in Australia.
Dr. William F. Balistreri: Individuals with IBS symptoms who were shown not to have celiac disease were given either a gluten-free baked product or identical product which contained gluten. Those who ingested gluten over a period of time reported significantly more and severe symptoms.
Dr. William F. Balistreri: Conversely, those ingesting the gluten-free products had less bloating, abdominal pain, fatigue and other symptoms.
Dr. William F. Balistreri: Another study published this month in the Journal of Gastroenterology also reported that a controlled diet of a gluten-free substance reduced symptoms in patients with diarrhea predominant IBS.
Dr. William F. Balistreri: I look forward to additional studies because there are several unanswered questions. Number one, is any improvement truly related to the avoidance of gluten or is it due to the placebo effect of eating what is perceived as a healthy or healthier diet?
Dr. William F. Balistreri: And number two, is the effect related to gluten elimination or the restriction of wheat? Clearly, this distinction is important since the natural history of celiac disease versus that of gluten sensitivity is quite different.
Dr. William F. Balistreri: In addition, it is neither simple nor inexpensive to restrict gluten from the diet since items such as pizza, bread, pasta make up a significant proportion of the daily intake.
Dr. William F. Balistreri: The bottom line—gluten restriction may prove to be an option for certain individuals with IBS. However, we strongly recommend that you speak with your physician and that celiac disease is excluded prior to choosing a gluten-free diet.