Gluten Intolerance Symptoms and Management

Gluten intolerance symptoms can include various digestive problems, cognitive dysfunction, joint pain, skin rash, and mood issues. These symptoms are similar to celiac disease, but while both are related to eating gluten, they are different conditions.

Non-celiac gluten intolerance occurs when you react negatively to gluten but don't have an autoimmune disease that damages the intestines. The only way to confirm that your symptoms are related to gluten intolerance and not celiac is with tests performed by a healthcare provider.

Signs of Gluten Intolerance

With non-celiac gluten intolerance, your body can’t tolerate gluten, a protein found in grains like wheat, barley, and rye. When you eat these foods, your body reacts with inflammation. The inflammation often affects your intestines, but you can have gluten intolerance and not have digestive issues.

Other body systems may be impacted whether or not digestion is affected; these include the skin, joints, and brain.

Symptoms of gluten intolerance include:

• Bloating
• Diarrhea
• Constipation
• Gas
• Nausea
• Vomiting
• Abdominal pain
• Fatigue
• Headache and/or migraine
• Body aches
• Brain fog
• Sleep disorders
• Skin rashes
• Joint pain
• Neuropathy (nerve damage) and/or tingling
• Depression and/or anxiety
• Fertility issues
• Irregular menstrual periods
  

Everyone's experience of gluten intolerance is different. For some people, the first signs of gluten intolerance are bloating or diarrhea after a big pasta meal. For others, it may be fatigue, brain fog, or depression that comes on gradually and is more challenging to associate with eating a specific meal.

Gluten intolerance can begin at any age and symptoms may change with time.

Gluten Intolerance vs. Celiac Disease

A gluten flare-up can feel the same for celiac disease and gluten intolerance since the symptoms are similar for both. The difference is that with celiac disease, gluten also causes irreversible damage to the small intestines, which can lead to other health issues. These issues can include anemia, weight loss, and severe medical disorders.

Another factor related to celiac is the presence of other autoimmune diseases, such as type 1 diabetes, autoimmune thyroiditis, or dermatitis herpetiformis. You may start out with a different autoimmune disorder and then develop celiac or vice versa.

However, research shows that the risk of developing another autoimmune disease is lower for people with celiac if they follow a gluten-free diet.

Common Foods to Avoid 

Gluten is a protein found in wheat, barley, and rye; it is prevalent in the Western diet. Most people consume gluten every single day in varying amounts.

If you have gluten intolerance, these are common gluten-containing foods to avoid:

• Bread
• Pasta/noodles
• Cookies
• Cake
• Baked goods
• Crackers
• Beer
• Flour
• Oats (that are not certified gluten-free)
• Couscous
• Certain salad dressings, marinades, stock cubes, candies, and more

Many types of traditional grains and baked goods are now available with gluten-free ingredients. Check the package label to be sure.

It's normal to struggle to adjust to a gluten-free diet. Consider seeing a dietitian who specializes in the gluten-free diet to help you with this process.

Diagnosis

The only way to differentiate gluten intolerance from celiac disease or wheat allergy is to go through the proper diagnostic process to rule out those conditions first.

Testing typically involves the following:

• An allergy test to rule out wheat allergy
• A blood test for celiac disease markers
• An endoscopy and biopsy to retrieve and test tissue samples of the intestines if the blood test is borderline

People with gluten intolerance will test negative on blood tests and biopsies. However, they still have a suspected response to eating gluten.

If you have a negative blood test, your healthcare provider may guide you through an elimination diet or gluten challenge to confirm that your symptoms are truly coming from eating gluten and not something else. A dietitian and gastroenterologist specializing in gluten-related disorders can help you with this.

About 6% of the general population have been diagnosed with non-celiac gluten intolerance.

Treatment

As with celiac disease, the only medical treatment for gluten intolerance is to follow a gluten-free diet. However, the degree of strictness of this gluten-free diet may differ for people with gluten intolerance vs. people with celiac.

People with celiac disease must avoid all cross-contact with gluten since microscopic amounts can trigger an autoimmune response and damage the small intestine, even without symptoms. This means using clean cutting boards and utensils, clean water to boil gluten-free pasta, uncontaminated frying oil, and more.

People with gluten intolerance do not have the same internal damage when they eat gluten. As such, minimal gluten consumption is acceptable up to the point that it causes symptoms. For this reason, someone with gluten intolerance may be able to tolerate amounts of cross-contact.

Summary

Gluten intolerance is different from celiac disease because there is no autoimmune process. However, people with gluten intolerance can have all the same symptoms as celiac, including bloating, nausea, vomiting, diarrhea, skin rashes, constipation, brain fog, and more. The only treatment for gluten intolerance is a gluten-free diet.