Non-Celiac Gluten Sensitivity

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KEY POINTS

• Gluten is a protein found in wheat, rye, barley, and some other grains and foods. If your child has gluten sensitivity or intolerance, he has a reaction, such as upset stomach or gas when he eats foods that contain gluten.
• Gluten sensitivity is treated with a gluten-free diet. A gluten-free diet contains no wheat, barley, or rye. Fresh fruits, vegetables, beans, milk, fresh beef, pork, poultry, fish, and eggs do not contain gluten. Nuts, seeds, and vegetable oils without additives are also safe.
• For most people, this diet relieves symptoms in a few weeks.

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What is non-celiac gluten sensitivity?

Gluten is a protein found in wheat, rye, barley, and some other grains and foods. If your child has gluten sensitivity or intolerance, your child has a reaction, such as upset stomach or gas when he eats foods that contain gluten.

Gluten sensitivity is not the same as an allergy or celiac disease. If your child has an allergy to wheat, rye, or barley, eating these foods can cause hives, swelling, dizziness, or trouble breathing. If your child has celiac disease, eating gluten damages the lining of the small intestine and makes it hard for your child’s intestines to absorb nutrients from food.

What is the cause?

The exact cause of non-celiac gluten sensitivity is not known.

What are the symptoms?

Some people start having symptoms as children, others later in life. The symptoms vary a lot from one person to the next.

Digestive symptoms may include:

• Belly pain or cramps
• Gas and bloating
• Diarrhea or constipation

Other symptoms may happen hours or days after your child eats gluten and involve other parts of the body. These symptoms may include:

• Feeling unusually tired
• Headache
• Joint pain
• Numbness in the legs, arms, or fingers
• Trouble focusing and concentrating

How is it diagnosed?

Your healthcare provider will ask about your child’s symptoms and medical history and examine your child. There is no test for gluten sensitivity. Your child may have tests to check for other problems, such as allergies or celiac disease. These tests may include:

• Blood tests
• Biopsy, which is the removal of a small sample of tissue from the intestine for testing

If these tests are normal, your provider may suggest that your child stop eating any foods that contain gluten and see if symptoms get better. If your child’s symptoms do get better, your provider may want your child to try food with gluten again to see if symptoms come back.

How is it treated?

The only treatment for gluten sensitivity is a gluten-free diet. For most children, this diet relieves symptoms in a few weeks.

What is a gluten-free diet?

A gluten-free diet contains no wheat, barley, or rye. Because the American diet is based on grains and many processed foods contain grain-based additives, this diet can be hard to follow. You may need to work with a dietitian to help your child eat a healthy, gluten-free diet. Here are some suggestions:

• Grains are high in carbohydrates, also called carbs, which are a source of energy and nutrients. It is important to replace carbs from wheat, rye, and barley with carbs from foods such as wild rice, quinoa, millet, corn, and potatoes.
• Fresh fruits, vegetables, beans, milk, fresh beef, pork, poultry, fish, and eggs do not contain gluten. Nuts, seeds, and vegetable oils without additives are also safe.
• Any product with a “gluten-free” label is usually OK to eat. Some food products are certified by the Gluten Free Certification Organization (GFCO) and have a GFCO stamp on them. The GFCO tests for the amount of gluten in a product and has strict standards.
• Always read labels to check for gluten, but remember that "wheat free" doesn't always mean "gluten free." Wheat-free products may contain barley or rye.
• Many companies will send you a list of their gluten-free products. If you have any question about whether a food contains gluten, your child should avoid the product until you check with the manufacturer.
• When you eat at a restaurant or deli, ask if they have a gluten-free menu. Order foods without sauces since wheat flour is used as a thickener in many sauces.

Your healthcare provider may prescribe a daily gluten-free multivitamin and mineral supplement. Ask your pharmacist or call the manufacturer to find out about the ingredients in your child’s medicine.

Ask your healthcare provider:

• How and when you will get your child’s test results
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup.