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Gluten gets blamed for countless digestive symptoms, but is it really the problem? In this episode, we explore the difference between celiac disease and non-celiac gluten sensitivity (non-celiac wheat sensitivity), and why some people who feel better gluten-free may actually be reacting to something else.
I’m joined by Dr. Stefano Guandalini, co-founder of the University of Chicago’s Celiac Disease Center, and Associate Professor Jessica Biesiekierski, a leading researcher in non-celiac gluten sensitivity.
We cover celiac symptoms and diagnosis, the role of blood tests and biopsies. Gluten, fructans (FODMAP), the placebo and nocebo effect, and why “non-celiac gluten sensitivity” may not be the most accurate term. We also discuss why people often eliminate gluten and other foods without ever identifying what’s actually causing their symptoms.
In this episode, we discuss:
- Why celiac disease is so often missed, even by doctors
- How celiac disease is diagnosed through blood testing and biopsy
- What the research really shows about gluten versus fructans (FODMAP) and other triggers
- The role of the gut-brain connection in non-celiac gluten sensitivity
- Why cutting out food before testing can make diagnosis harder
If you've ever wondered whether gluten is really the issue, or suspected it might be something else in your diet, this conversation will give you a much clearer picture.
Timestamps:
00:00 Introduction to the episode and guests
05:50 Celiac disease prevalence and why rates are rising
09:32 Why celiac disease is so difficult to diagnose
13:19 Celiac disease symptoms, gastrointestinal and beyond
16:04 How celiac disease is diagnosed: blood tests and biopsy
20:43 What to do if you're already gluten-free before getting tested
22:45 Why you shouldn't eliminate gluten before celiac testing
25:33 What is non-celiac gluten sensitivity
31:08 What the research shows about gluten-specific reactions
32:54 Why "gluten sensitivity" may be the wrong term
40:41 Why people feel better gluten-free, even without a gluten reaction
46:15 The nocebo effect and the gut-brain connection explained
52:51 A new research study recruiting IBS patients
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