Non-celiac gluten sensitivity (NCGS) applies to those individuals who cannot tolerate gluten and experience symptoms similar to those of celiac disease.  However, NCGS patients lack the same antibodies and intestinal damage as those with celiac disease.  NCGS not only presents as GI symptoms, but also non-GI symptoms such as headache, “foggy mind,” joint pain, and numbness.   In general, the symptoms of non-celiac gluten sensitivity are not as severe as celiac disease.  In some cases, patients can eat gluten in moderation.  NCGS is caused by a completely different immune response to gluten from celiac disease.  NCGS is not an autoimmune disease and does not relate to reactive antibodies or the genes HLA-DQ2 or DQ8.  While there may be other genes involved in NGCS, more research is necessary to identify a specific genetic link.

Irritable bowel syndrome (IBS) affects up to 15% of the population.  People with IBS may have urgent diarrhea, constipation, a combination of both, or simply have gas and bloating.  The etiologies of IBS are not completely clear, however, it is frequently associated with fibromyalgia syndrome.  A subset of people with IBS, but without celiac disease, suffer from NCGS  and see their IBS symptoms improve or even resolve completely when they eat a gluten-free diet.

Celiac disease, non-celiac gluten sensitivity and IBS are different conditions.  Before jumping into a gluten-free diet, the correct diagnosis must be confirmed through patient history, blood tests, small intestine biopsy or even genetic testing.  The correct diagnosis is crucial for long term management of each specific disorder.

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