In recent years the popularity of gluten-free diets has skyrocketed, even among people who don’t have celiac disease. Some people do it to lose weight* or because they’ve heard wheat is bad for you.** Then there are the people who say that even without celiac disease, eating wheat makes them sick. Those people have often been discounted. But now, Columbia University scientists say, they’ve been vindicated. The researchers found a weakened gut lining in people with non-celiac wheat sensitivity (NCWS). The results were published in the journal Gut.

"Our study shows that the symptoms reported by individuals with this condition are not imagined, as some people have suggested," co-author Peter H. Green, the director of the Celiac Disease Center at Columbia University Medical Center, said in a press statement.

For a supposedly imaginary condition, NCWS has some consistent symptoms: people who identify as gluten-intolerant typically report abdominal pain, bloating, diarrhea, constipation, depression, fatigue, inflammation, and cognitive issues shortly after eating wheat. And all of these symptoms, including depression and fatigue, have been linked to problems in the gut.

Researchers decided to take a very close look at the guts of people with NCWS. They recruited 80 people with the condition, 40 people with celiac disease, and 40 people with no wheat problems of any kind. Then they collected blood samples from everyone and tested them for various markers of immune activation.

They found that, despite the havoc celiac disease can wreak on the body, people with the condition showed no more immune response than the healthy controls. The NCWS group was not so lucky. Their blood showed significantly higher levels of systemic inflammation and reactivity, and markedly higher levels of a protein that signifies damage to the intestinal lining. Most compelling was the finding that people with NCWS who had cut wheat out of their diets showed far less inflammation than people who hadn’t.

The authors note that their study did not identify the trigger of inflammation in people with NCWS, only the inflammation itself. The culprit might not be gluten at all, but some other wheat compound.

Either way, the authors say, these results show that NCWS is a real medical issue that needs medical and scientific attention.

*This does not work.

**In moderation, it isn’t, unless you have celiac disease or non-celiac wheat sensitivity.

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