How To Reverse Gluten Intolerance

Why is it that some people can eat gluten with no problems while others seem to react negatively to gluten? 

In this article, we look at the science of gluten intolerance: what causes it, how to manage it, and whether it can be reversed.

Gluten intolerance, also known as non-coeliac gluten sensitivity or non-coeliac wheat sensitivity, is when the body has a negative reaction to gluten consumption. Gluten-sensitive patients often experience digestive issues such as bloating, abdominal pain and diarrhoea. Gluten intolerance cannot be cured or reversed, though it can be managed by adopting a gluten-free diet.

Additionally, while gluten intolerance is often confused with coeliac disease as both condition's symptoms are triggered by gluten exposure, they are two different diagnoses. There are several steps gluten-sensitive patients can take to manage their symptoms and to prevent them from appearing at all. 

What is gluten intolerance?

Gluten intolerance is a condition in which gluten consumption causes a negative reaction in the body - the body does not “tolerate” gluten. Eating gluten may cause digestive problems like bloating, abdominal pain and indigestion.¹

What is gluten?

Gluten is a protein found in cereals such as wheat, barley and rye. These cereals, especially wheat, are used to make many different types of foods and can be found in various food products such as:

• Regular bread
• Cakes
• Muffins and doughnuts
• Cookies and biscuits
• Pasta
• Breakfast cereals
• Beer (contains barley) 

These foods should be avoided if you have a gluten intolerance; however, there are several replacement gluten-free food options available. Gluten-free bread is made from plant flours that do not contain gluten, such as rice, sorghum, millet, and cassava flour. As gluten is elastic, it gives regular bread a soft, stretchy texture.² 

In contrast, some find gluten-free bread to be more brittle or crumbly in texture compared to regular bread and also produce a smaller, denser loaf.¹ Regular bread also has a longer shelf-life than gluten-free bread.

Gluten intolerance vs coeliac disease 

Coeliac disease is an autoimmune disease in which gluten exposure causes the body’s immune system to attack its own cells. Coeliac disease has a genetic component, which means it often runs in the family. During digestion, gluten is not fully broken down by digestive enzymes (substances in the body that help to speed up chemical reactions) in the small intestine. This triggers cells of the immune system to attack the lining of the small intestine.¹

The difference between gluten intolerance and coeliac disease is that gluten intolerance is not an autoimmune disease. Gluten intolerance is sometimes referred to as non-coeliac gluten sensitivity (NCGS) or non-coeliac wheat sensitivity because the bodily reaction to gluten exposure does not involve the immune system cells attacking the lining of the small intestine.¹

In the short term, coeliac disease and gluten intolerance have similar symptoms that affect the digestive system. However, patients with coeliac disease will acquire damage to the intestinal lining with long-term gluten exposure, which can affect the absorption of nutrients from food. Over time, this can lead to malnutrition, fatigue and/or weight loss due to a lack of nutrients.¹

What causes gluten intolerance?

Scientists are still unclear on what causes gluten intolerance, and more research is needed to better understand this condition and how to help gluten-sensitive patients.³

What are the symptoms of gluten intolerance?

After eating food which contains gluten, gluten-sensitive people may experience a range of digestive symptoms, such as:

• Abdominal pain
• Bloating
• Indigestion
• Diarrhoea
• Nausea
• Constipation 

How is gluten intolerance diagnosed?

If you are experiencing symptoms that suggest gluten intolerance, it is advisable to see a doctor. The doctor may then refer you to a dietician who will carry out some diagnostic tests. 

You may be asked to switch to a gluten-free diet for a short period to see if the symptoms improve. A gluten-free diet means avoiding food that contains gluten, such as regular bread, pasta and most breakfast cereals. You also need to be careful when eating processed food that is made in the same place as gluten-containing products, as there is a risk of cross-contamination. If your symptoms improve after switching to a gluten-free diet, there is a chance that you might have gluten sensitivity.¹

You may also be asked to do a blood test. Since coeliac disease triggers the cells of the immune system, people with coeliac disease often have certain antibodies in their blood, while people with gluten intolerance or non-coeliac gluten sensitivity do not. So, the blood test will allow the doctor to determine whether you have coeliac disease or to rule it out.

In some cases, you could also be asked to do a biopsy. A biopsy is a procedure where some tissue is removed from the body and examined closely using a microscope to help make a diagnosis. The doctor takes tissue from the small intestine by inserting a tool inside a long flexible pipe (an endoscope), which goes into your mouth and down to the small intestine. The tissue will then be inspected using a microscope to check for coeliac disease.

Unless you have instructions from a medical professional to change to a gluten-free diet, it is important to continue eating gluten during the period of time you are taking the diagnostic tests. If you stop eating gluten, your body will not have any symptoms (there will be no signs of a reaction to gluten exposure in your body) so the tests will not work.

How can I prevent gluten intolerance?

Scientists are not yet sure how to prevent gluten intolerance. Some researchers suggest that the age you are first introduced to gluten might be an important factor in the development of coeliac disease later in life. However, more studies are needed and less still is known about the prevention of gluten intolerance or non-coeliac gluten sensitivity.^3,4

How can I treat gluten intolerance?

The symptoms of gluten intolerance can be treated by flushing gluten out of the body after gluten consumption. Removing gluten from the body as soon as possible can help to reduce the symptoms of gluten sensitivity. Drinking water and eating food that helps with digestion, like pears and prunes, can help remove gluten from the body faster.

To prevent symptoms from developing in the first place, it is advised that gluten-insensitive patients switch to a gluten-free diet. Avoiding food that contains gluten is a good way to prevent negative reactions to gluten exposure.¹

However, there are some disadvantages to adopting a gluten-free diet:

• Nutritional imbalance - Processed gluten-free products tend to have inadequate amounts of dietary fibre (important in preventing constipation and in lowering the risk of colon cancer, cardiovascular disease and type 2 diabetes) and low amounts of vitamins and minerals (such as vitamin C, B12 and D/iron, zinc and magnesium)⁴
• Taste and texture differences - Gluten-free bread has a different taste and texture to regular bread (denser and more brittle in comparison to regular bread), and it might take some time to get used to it²
• Psychological stress - Some people might find it difficult to remain vigilant about what they eat and may find eating out with friends or going grocery shopping more stressful than before they changed to a gluten-free diet, as accidental gluten exposure because of cross-contamination can be worrisome

Summary

Gluten intolerance is when the body has a negative reaction to eating gluten-containing food, such as regular bread, cakes, biscuits and breakfast cereals. Unlike coeliac disease, where gluten exposure causes the immune system to attack the lining of the small intestine, gluten intolerance is not an autoimmune disease. Scientists are still not clear on what causes gluten intolerance, and there is no cure for it. People with gluten intolerance can reduce their symptoms by changing to a gluten-free diet.