Digestive Health Celiac Disease Gluten Sensitivity Gluten Sensitivity Guide Gluten Sensitivity Guide Symptoms Causes Diagnosis Treatment Symptoms of Gluten Sensitivity By Jane Anderson facebook twitter Jane Anderson is a medical journalist and an expert in celiac disease, gluten sensitivity, and the gluten-free diet. Learn about our editorial process Jane Anderson Medically reviewed by Medically reviewed by Robert Burakoff, MD, MPH on June 05, 2020 linkedin Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York. Learn about our Medical Review Board Robert Burakoff, MD, MPH on June 05, 2020 Print Table of Contents View All Gastrointestinal Symptoms Extra-intestinal Symptoms Next in Gluten Sensitivity Guide Causes and Risk Factors of Gluten Sensitivity 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 disorientationAnxiety, which may be due to anticipation of abdominal painDepression, 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% Was this page helpful? Thanks for your feedback! Following a gluten-free diet can be challenging. We're here to help. Sign up and receive our free recipe guide for delicious gluten-free meals! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to 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: 10.1186/1741-7015-10-13 Biesiekierski JR, Iven J. Non-coeliac gluten sensitivity: Piecing the puzzle together. United European Gastroenterol J. 2015 Apr; 3(2): 160–165. doi:10.1177/2050640615578388 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 Volta U, Bardella MT, Calabrò A, Troncone R, Corazza GR. An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Med. 2014;12:85.doi:10.1186/1741-7015-12-85 Dimitrova AK, Ungaro RC, Lebwohl B, et al. Prevalence of migraine in patients with celiac disease and inflammatory bowel disease. Headache. 2013;53(2):344-55. doi:10.1111/j.1526-4610.2012.02260.x Ford R. The gluten syndrome: a neurological disease. Medical Hypotheses. 2009 Sep;73(3):438-40. doi:10.1016/j.mehy.2009.03.037 Volta U, Bardella MT, Calabrò A, Troncone R, Corazza GR. An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Med. 2014;12:85.doi:10.1186/1741-7015-12-85 Arthritis Foundation. The Connection Between Gluten and Arthritis. Additional Reading Al-Toma A, Volta U, Auricchio R, et al. European society for the study of coeliac disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterol J. 2019 Jun;7(5):583-613; doi:10.1177/2050640619844125 Busby E, Bold J, Fellows L, et al. Mood disorders and gluten: It’s not all in your mind! A systematic review with meta-analysis. Nutrients. 2018 Nov; 10(11): 1708. doi:10.3390/nu10111708 Harvard Health Publishing. Non-celiac gluten sensitivity. Dec 2014.