In our last post, we discussed Non-Celiac Gluten Sensitivity (NCGS) which is a less severe condition than celiac disease, but is much more common. To finish our series on gluten, let’s first consider how to make the diagnosis of NCGS.
If there is no test, how can I tell if I have NCGS?
Interestingly, it is often the patient himself (rather than the doctor) who make the diagnosis. Many NCGS suffers have noticed that after eating certain foods they feel sick, and many have read about gluten and wonder if they might have this problem. So they stop gluten and feel better.
This is the way to diagnose NCGS. If you suspect you have the problem, completely stop all foods containing gluten, for a week up to three weeks, and see if your symptoms get better. If they do, you should start eating gluten again to see if your symptoms return. If they do, then you likely have NCGS.
If I have NCGS, do I have to be totally off all gluten?
Probably not. Many people with NCGS can tolerate occasional doses of gluten—some greater amounts than others—and the only way to know is to challenge yourself with gluten at times. After you have been off gluten and your symptoms are better, try eating a little gluten and see what happens. If you still feel well, you can test even greater amounts of gluten and then stop when you find your limit. In this way you can detect if you need to totally stay off gluten or only reduce your intake.
I tried going off of gluten and it didn’t help. Now what?
If you really stopped all gluten for several weeks (after doing some dietary research, or consulting a nutritionist) and still feel no better, your symptoms are probably not gluten sensitivity. You might have something like Irritable Bowel Syndrome, or many other conditions, so you should consult a specialist.
But if you still believe your problems are related to something in your diet, another possibility of is that you are sensitive to the large group of carbohydrates (sugars) called “Fodmaps”. These include sugars such as fructose, lactose, and even the fiber contained in bananas, so here again you must do some research or talk to a nutritionist to know the correct diet.
Even if I don’t have NCGS, maybe I should just cut out gluten, right?
Some nutritional experts believe that we would be much healthier if we cut down on our gluten intake. So it’s a reasonable thing to try if you want. Just note that gluten-free foods are often more expensive, might not taste or look as nice, and you are giving up good sources of fiber, vitamins and nutrients that you will need to replace in other ways. The choice is yours. It’s a complicated issue, so best to consult a nutritionist or a doctor, preferably a gastroenterologist if you want to make major dietary changes.
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