Recently, there has been a fair amount of literature written in medical journals about non-celiac gluten sensitivity. In my practice, I see a number of patients that do not have celiac disease, but do feel better when they give up gluten. Interestingly, the vast majority of this subset of patients do have a genetic predisposition for celiac disease and have HLA subtypes DQ 2, and DQ 8. HLA-B is part of a family of genes called the HLA complex. The HLA complex helps the immune system distinguish the body’s own proteins from proteins made by foreign invaders such as viruses and bacteria. Virtually all patients with celiac disease also have this subtype.
With celiac disease, patients have a special type of allergy to wheat and exposure causes a component of the small intestine called villi to atrophy which impairs the person’s ability to absorb food and nutrients. Celiac patients often are found to be iron deficient, Vitamin D deficient and complain of frequent bowel movements as well as weight loss. We can screen for this disease by testing a patient’s blood to measure levels of anti-tissue transglutaminase antibodies. If the test is positive for these antibodies, a small bowel biopsy will be done to confirm or disprove the diagnosis of celiac disease.
By performing simple blood tests, we can determine, with a fair amount of certainty, if a patient is likely to be gluten sensitive.