Symptoms of Gluten Sensitivity

In This Article

The symptoms of non-celiac gluten sensitivity (NCGS, or simply gluten sensitivity) are divided into two broad categories: gastrointestional (GI) symptoms such as abdominal pain, bloating, and diarrhea, and extra-intestinal manifestations that include neurological symptoms such as "brain fog" and systemic ones (overall malaise, fatigue, and more).

These symptoms are often strikingly similar to those of celiac disease (CD) and wheat allergy and so diagnosis of NCGS is contingent not only on these shared potential symptoms of the disorder but also on ruling out CD and wheat allergy.

Symptoms associated with NCGS develop within a few hours to a day of ingesting gluten, disappear as soon as gluten is removed from the diet, and do not reappear as long as gluten is avoided.

Gastrointestinal Symptoms

Digestive issues are the most common symptoms reported by people with non-celiac gluten sensitivity. These tend to mimic those of irritable bowel syndrome, or IBS. (In fact, IBS has been found in some research to be an associated disorder.)

The most common GI manifestations of gluten sensitivity are represented well by a 2014 study of patients with NCGS in 38 medical centers in Italy.

Incidence of GI Symptoms of Gluten Sensitivity
Symptom Prevalence
Abdominal pain 83%
Diarrhea 54%
Epigastric pain (pain just below the ribcage) 52%
Nausea 44%
Aerophagia (excessive air swallowing) 36%
Gastroesophageal reflux 32%
Aphthous stomatitis (mouth ulcers) 31%
Alternating bowel habits 27%
Constipation 24%

Extra-intestinal Symptoms

Symptoms that do not affect GI function are more common in gluten sensitivity than in celiac disease. These often are divided into neurological or behavioral symptoms and systemic symptoms.

Behavioral/neurological symptoms

Among the most common of these are:

  • Chronic headache: A study in the journal Headache found that about 56% of those with gluten sensitivity had chronic headaches.
  • Brain fog, characterized by difficulty concentrating, short-term memory lapses, confusion, and disorientation
  • Anxiety, which may be due to anticipation of abdominal pain
  • Depression, possibly a result of a chronic health problem, although there is some evidence gluten may directly affect brain function. In addition, there also has been research showing increased depression among people with gluten sensitivity after undergoing a gluten challenge.
  • Neuropathy. Numbness or the sensation of "pins and needles" in the arms and legs is often experienced by people with gluten sensitivity. For example, in the Italian medical center study, 32% of subjects experienced these symptoms.

Systemic symptoms

In the Italian study, 68% of patients reported feeling feeling generally unwell. Fatigue also was prevalent, affecting 64% of patients.

Joint and muscle pain described as similar to the discomfort characteristic of fibromyalgia also is often associated with non-celiac gluten sensitivity. There is some speculation it's due to gluten-induced inflammation.

Some people with NCGS develop skin changes. In a study out of the University of Maryland's Center of Celiac Research, 40% of patients with gluten sensitivity developed a rash and/or eczema.

The spectrum of non-GI symptoms that have been linked to gluten sensitivity extend beyond these most notable ones, including several quantified in the Italian study.

Extra-intestinal Symptoms of Gluten Sensitivity
Symptom Incidence
Overall feeling of being unwell 68%
Fatigue 64%
Headache 54%
Anxiety (believed to be caused by anticipation of abdominal pain) 39%
Ataxia, or "brain fog" 38%
Numbness/pins and needles in extremities 32%
Joint and/or muscle pain (similar to that associated with fibromyalgia) 31%
Skin rash 29%
Weight loss 25%
Anemia 23%
Depression 18%
Dermatitis 10%
Rhinitis 5%
Asthma 3%
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Additional Reading