Table of ContentsView AllTable of ContentsDo Gluten Intolerance Tests Exist?CausesSymptomsDiagnosisFrequently Asked QuestionsNext in Gluten Sensitivity GuideHow Non-Celiac Gluten Sensitivity Is Treated
Table of ContentsView All
View All
Table of Contents
Do Gluten Intolerance Tests Exist?
Causes
Symptoms
Diagnosis
Frequently Asked Questions
Next in Gluten Sensitivity Guide
Currently, there are no reliablegluten sensitivityor gluten intolerance tests. Gluten sensitivity is sometimes mistaken forceliac disease, a gluten-related autoimmune condition. You can be tested for celiac disease, but these tests can’t determine if you’re sensitive to gluten.
If you havesymptoms of gluten intolerance, your healthcare provider will test you for celiac disease. If celiac disease is not the cause of your symptoms, your provider will need to rule out all the other possible causes before diagnosing you with gluten sensitivity.
This article will go over how gluten intolerance is diagnosed. It also describes what tests are available, including at-home gluten test kits, and when screening is recommended.
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Gluten Intolerance Test: Does It Exist?
There are currently no specific tests available for healthcare providers to diagnosegluten intolerance. The diagnosis is based on ruling out all other causes of a person’s symptoms, including celiac disease (for which there are tests).
Causes of Non-Celiac Gluten Intolerance
The causes of gluten intolerance are unknown, but there are some theories.
For example, some research suggests that gluten sensitivity is related to other components found in gluten-containing cereal grains.
One idea is that a collection of short-chain carbohydrates (sugars) calledFODMAPs(fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) could be involved. These sugars are found in all gluten-containing grains and are not well absorbed in the intestines. When they start to ferment, they cause symptoms of gas, bloating, diarrhea, and abdominal pain.
Other research suggests that proteins calledamylase/trypsin inhibitors(ATIs) that are found in all gluten-containing grains could cause an allergic reaction and trigger symptoms of gluten intolerance in some people.
The findings from research studies are not consistent, and it could be that “gluten intolerance” is a broad range of related and unrelated reactions to one or several components in gluten-containing grains.
Symptoms of Non-Celiac Gluten Intolerance
The first symptoms of gluten intolerance vary from one person to the next, both in type and severity. Some people find that the symptoms of a gluten flare show upwithin an hourof being exposed to gluten, while others may not have symptomsfor a day or twoafter being “glutened.”
A gluten flare-up can include gastrointestinal symptoms like bloating (which can be extreme, often called “gluten belly”) as well as non-gastrointestinal symptoms, like skin or cognitive problems.
Troublesome symptoms of gluten intolerance may include:
Diagnosing Gluten Sensitivity Without a Test
The diagnosis of gluten intolerance will usually involve the following steps:
Gluten Intolerance vs. Celiac Disease: How to Tell the Difference
Ruling Out Other Conditions
The exclusion of possible causes is called adifferential diagnosis. This process helps your provider eliminate possible causes from their list until they get to the one that is the most likely explanation for your symptoms.
A differential diagnosis is important when test results are uncertain and even more important when no tests are available, such as in the case of gluten sensitivity.
If your provider thinks your symptoms have a gluten-related cause, there are a few conditions that they will want to explore:
IBS vs. Celiac Disease vs. Gluten Sensitivity: How Do I Know Which One I Have?
Gluten Challenge
A gluten challenge is not the same thing as a gluten-free diet. A gluten challenge is a test used to see if the cause of your symptoms is gluten or something else. It can be an option if there is any uncertainty about the diagnosis.
A gluten challenge takes place after you have been on a gluten-free diet for at least six weeks.
For the challenge, your provider will do a"blinded" testin which you are either given a food with gluten in it or an equivalent of that food with no gluten. You will not know which is which.
The gluten challenge is done in steps over the course of three weeks:
At the end of the challenge, you and your provider will compare the results.
How to Prepare for a Gluten Challenge
Tests for Celiac Disease
Although there are tests to diagnose celiac disease, it’s not always a straightforward process.
Blood Tests
There are several blood tests that can detect markers for celiac disease, including autoantibodies and genetic mutations linked to the disease. These tests include:
Endoscopy
If the results of the blood tests show celiac disease, the next step is to do procedures to see the insides of the intestines.
Providers do these tests to look forvillous atrophy, a condition in which the finger-like projections in the lining of the intestines (villi) are flattened and destroyed.
There are two ways your gastroenterologist can do these procedures:
Biopsy
While villous atrophy is a central feature of celiac disease, it can happen with other diseases as well. A sample of tissue will need to be taken from the intestine and looked at in a lab with a microscope (biopsy) to make the diagnosis official. The biopsy sample can be taken during the scope procedures.
An intestinal biopsy is the “gold standard” for diagnosing celiac disease.
How Celiac Disease Is Diagnosed
Home Testing for Gluten Sensitivity
There are several at-home kits you can buy that are said to test for various food sensitivities, including gluten sensitivity. These require either a small sample of stool (poop) or a finger-prick blood sample. Brands of at-home gluten tests include EverlyWell and EnteroLab.
Who Should Get Tested for Celiac Disease?According to the Celiac Disease Foundation, the following groups should be screened for celiac disease:Children older than 3 years and adults having symptoms of celiac diseaseParents, siblings, or children of someone diagnosed with celiac diseaseAny person with an associated autoimmune disease or genetic disorder, especiallytype 1 diabetes,autoimmune thyroid disease,autoimmune liver disease,Down syndrome,Turner syndrome,Williams syndrome, andselective immunoglobulin A (IgA) deficiency
Who Should Get Tested for Celiac Disease?
According to the Celiac Disease Foundation, the following groups should be screened for celiac disease:Children older than 3 years and adults having symptoms of celiac diseaseParents, siblings, or children of someone diagnosed with celiac diseaseAny person with an associated autoimmune disease or genetic disorder, especiallytype 1 diabetes,autoimmune thyroid disease,autoimmune liver disease,Down syndrome,Turner syndrome,Williams syndrome, andselective immunoglobulin A (IgA) deficiency
According to the Celiac Disease Foundation, the following groups should be screened for celiac disease:
Summary
Gluten intolerance or gluten sensitivity (non-celiac gluten sensitivity) shares many symptoms with celiac disease. However, these are not the same conditions.
Celiac disease is an autoimmune disease that can be diagnosed with a combination of antibody blood tests, genetic blood tests, endoscopy, and an intestinal biopsy.
How Gluten Intolerance Is Treated
People have been known to develop gluten intolerance (non-celiac gluten sensitivity) after severe bouts ofgastroenteritis(the “stomach flu”).Other severe infections or diseases of the gastrointestinal tract may change how your body processes gluten and lead to intolerance.
People have been known to develop gluten intolerance (non-celiac gluten sensitivity) after severe bouts ofgastroenteritis(the “stomach flu”).
Other severe infections or diseases of the gastrointestinal tract may change how your body processes gluten and lead to intolerance.
If you have a wheat allergy, you can react to any one of four allergy-causing substances in wheat—albumin, globulin, gliadin, and gluten. Any one of these four proteins can be the cause of your symptoms.Learn MoreFoods to Avoid If You Have a Wheat Allergy
If you have a wheat allergy, you can react to any one of four allergy-causing substances in wheat—albumin, globulin, gliadin, and gluten. Any one of these four proteins can be the cause of your symptoms.
Learn MoreFoods to Avoid If You Have a Wheat Allergy
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sapone A, Bai JC, Ciacci C, et al.Spectrum of gluten-related disorders: consensus on new nomenclature and classification.BMC Med. 2012;10:13. doi:10.1186/1741-7015-10-13Catassi C, Elli L, Bonaz B, et al.Diagnosis of non-celiac gluten sensitivity (NCGS): the Salerno Experts' criteria.Nutrients. 2015;7(6):4966–4977. doi:10.3390/nu7064966Elli L, Tomba C, Branchi F, et al.Evidence for the presence of non-celiac gluten sensitivity in patients with functional gastrointestinal symptoms: results from a multicenter randomized double-blind placebo-controlled gluten challenge.Nutrients. 2016;8(2):84. doi:10.3390/nu8020084Schuppan D, Zimmer KP.The diagnosis and treatment of celiac disease.Dtsch Arztebl Int.2013 Dec;110(49):835–46. doi:10.3238/arztebl.2013.0835Freeman JH.Role of biopsy in diagnosis and treatment of adult celiac disease.Gastroenterol Hepatol Bed Bench.2018 Summer;11(3):191–6.Murch S, Jenkins H, Auth M, et al.Joint BSPGHAN and Coeliac UK guidelines for the diagnosis and management of coeliac disease in children.Arch Dis Child.2013 Oct;98(10):806-11. doi:10.1136/archdischild-2013-303996Celiac Disease Foundation.Testing.Rostami K, Rostami-Nejad M, Al Duliami D.Post gastroenteritis gluten intolerance.Gastroenterol Hepatol Bed Bench.2015 Winter;8(1):66–70.American College of Allergy, Asthma, & Immunology.Wheat.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sapone A, Bai JC, Ciacci C, et al.Spectrum of gluten-related disorders: consensus on new nomenclature and classification.BMC Med. 2012;10:13. doi:10.1186/1741-7015-10-13Catassi C, Elli L, Bonaz B, et al.Diagnosis of non-celiac gluten sensitivity (NCGS): the Salerno Experts' criteria.Nutrients. 2015;7(6):4966–4977. doi:10.3390/nu7064966Elli L, Tomba C, Branchi F, et al.Evidence for the presence of non-celiac gluten sensitivity in patients with functional gastrointestinal symptoms: results from a multicenter randomized double-blind placebo-controlled gluten challenge.Nutrients. 2016;8(2):84. doi:10.3390/nu8020084Schuppan D, Zimmer KP.The diagnosis and treatment of celiac disease.Dtsch Arztebl Int.2013 Dec;110(49):835–46. doi:10.3238/arztebl.2013.0835Freeman JH.Role of biopsy in diagnosis and treatment of adult celiac disease.Gastroenterol Hepatol Bed Bench.2018 Summer;11(3):191–6.Murch S, Jenkins H, Auth M, et al.Joint BSPGHAN and Coeliac UK guidelines for the diagnosis and management of coeliac disease in children.Arch Dis Child.2013 Oct;98(10):806-11. doi:10.1136/archdischild-2013-303996Celiac Disease Foundation.Testing.Rostami K, Rostami-Nejad M, Al Duliami D.Post gastroenteritis gluten intolerance.Gastroenterol Hepatol Bed Bench.2015 Winter;8(1):66–70.American College of Allergy, Asthma, & Immunology.Wheat.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sapone A, Bai JC, Ciacci C, et al.Spectrum of gluten-related disorders: consensus on new nomenclature and classification.BMC Med. 2012;10:13. doi:10.1186/1741-7015-10-13Catassi C, Elli L, Bonaz B, et al.Diagnosis of non-celiac gluten sensitivity (NCGS): the Salerno Experts' criteria.Nutrients. 2015;7(6):4966–4977. doi:10.3390/nu7064966Elli L, Tomba C, Branchi F, et al.Evidence for the presence of non-celiac gluten sensitivity in patients with functional gastrointestinal symptoms: results from a multicenter randomized double-blind placebo-controlled gluten challenge.Nutrients. 2016;8(2):84. doi:10.3390/nu8020084Schuppan D, Zimmer KP.The diagnosis and treatment of celiac disease.Dtsch Arztebl Int.2013 Dec;110(49):835–46. doi:10.3238/arztebl.2013.0835Freeman JH.Role of biopsy in diagnosis and treatment of adult celiac disease.Gastroenterol Hepatol Bed Bench.2018 Summer;11(3):191–6.Murch S, Jenkins H, Auth M, et al.Joint BSPGHAN and Coeliac UK guidelines for the diagnosis and management of coeliac disease in children.Arch Dis Child.2013 Oct;98(10):806-11. doi:10.1136/archdischild-2013-303996Celiac Disease Foundation.Testing.Rostami K, Rostami-Nejad M, Al Duliami D.Post gastroenteritis gluten intolerance.Gastroenterol Hepatol Bed Bench.2015 Winter;8(1):66–70.American College of Allergy, Asthma, & Immunology.Wheat.
Sapone A, Bai JC, Ciacci C, et al.Spectrum of gluten-related disorders: consensus on new nomenclature and classification.BMC Med. 2012;10:13. doi:10.1186/1741-7015-10-13
Catassi C, Elli L, Bonaz B, et al.Diagnosis of non-celiac gluten sensitivity (NCGS): the Salerno Experts' criteria.Nutrients. 2015;7(6):4966–4977. doi:10.3390/nu7064966
Elli L, Tomba C, Branchi F, et al.Evidence for the presence of non-celiac gluten sensitivity in patients with functional gastrointestinal symptoms: results from a multicenter randomized double-blind placebo-controlled gluten challenge.Nutrients. 2016;8(2):84. doi:10.3390/nu8020084
Schuppan D, Zimmer KP.The diagnosis and treatment of celiac disease.Dtsch Arztebl Int.2013 Dec;110(49):835–46. doi:10.3238/arztebl.2013.0835
Freeman JH.Role of biopsy in diagnosis and treatment of adult celiac disease.Gastroenterol Hepatol Bed Bench.2018 Summer;11(3):191–6.
Murch S, Jenkins H, Auth M, et al.Joint BSPGHAN and Coeliac UK guidelines for the diagnosis and management of coeliac disease in children.Arch Dis Child.2013 Oct;98(10):806-11. doi:10.1136/archdischild-2013-303996
Celiac Disease Foundation.Testing.
Rostami K, Rostami-Nejad M, Al Duliami D.Post gastroenteritis gluten intolerance.Gastroenterol Hepatol Bed Bench.2015 Winter;8(1):66–70.
American College of Allergy, Asthma, & Immunology.Wheat.
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