Gluten sensitivity is often suspected as the underlying cause of abdominal pain, bloating or chronic diarrhoea. As this condition has a significant impact on daily life, an accurate diagnosis and lifestyle changes guided by a specialist are essential.
From Endomedix Gastroenterology Centre This summary helps to clarify the concepts and set out the path to becoming complaint-free.
Types of gluten-related disorders
It is important to understand that „gluten sensitivity” is an umbrella term covering three distinct conditions:
| Disease | Nature | Key features |
| Coeliac disease | Autoimmune | The villi in the intestine atrophy, leading to malabsorption and nutritional deficiencies. It requires a strict, lifelong diet. |
| Wheat allergy | Classic allergy | Immediate reaction (itching, swelling, or even anaphylaxis). Only wheat needs to be avoided. |
| NCGS (Non-coeliac gluten sensitivity) | Sensitivity | Diagnosis by exclusion: the symptoms are genuine, but there is no autoimmune response or classic allergy. |
How is the diagnostic process carried out?
Never start a diet before your medical tests! If you stop eating gluten before having the tests, the results may be false negatives, meaning that coeliac disease may go undiagnosed.
The stages of the examination at Endomedix:
- Blood test: Screening for specific antibodies (e.g. tTG).
- Genetic screening (HLA-DQ2/DQ8): It helps to rule out a predisposition.
- Gastroscopy (biopsy): Histological examination of the condition of the villi of the small intestine (even under general anaesthesia).
- Diagnosis by exclusion: If the autoimmune and allergy tests are negative, but cutting out gluten leads to an improvement, we are talking about NCGS.
The basics of a gluten-free diet
The basis of this lifestyle change is the complete elimination of forbidden grains (wheat, barley, rye).
What can you eat?
- Wholemeal cereals: Rice, maize, millet, buckwheat, quinoa, amaranth.
- Fresh ingredients: Vegetables, fruit, meat, fish, eggs.
- Natural dairy products: Milk, cottage cheese, yoghurt (plain).
- Products guaranteed to be gluten-free: Those bearing the symbol of a crossed-out ear of corn.
Hidden sources of gluten – Watch out for these!
Many foods contain gluten as a texturiser: cold cuts, ready meals, sauces (e.g. soya sauce), beer, soup powders and certain spice mixes.
Practical tips for everyday life
- Tag reading: Always check the ingredients and look for the „gluten-free” label.
- Preventing cross-contamination: If you have coeliac disease, you need a separate chopping board, a separate toaster and a thoroughly clean kitchen.
- In a restaurant: Please check in advance and inform the waiter of any allergies or sensitivities.
- Involvement of a dietitian: It helps to prevent nutrient deficiencies (e.g. fibre, iron or vitamin $B$ deficiency), which can occur if your diet is poorly balanced.
