Gluten sensitivity—medically known as non-celiac gluten sensitivity (NCGS)—is increasingly recognised globally as a condition where symptoms arise from gluten ingestion, despite normal tests for celiac disease and wheat allergy. In India, where wheat is a staple for millions (especially across the North and Central zones), emerging data indicate rising awareness and growing numbers of cases.
Symptoms often resemble irritable bowel syndrome (IBS)—bloating, abdominal pain, diarrhea or constipation—as well as broader systemic issues like fatigue, “brain fog,” joint pain, depression, skin rashes, anemia, or tingling in hands and feet. These overlapping symptoms make screening essential.
If someone suspects gluten sensitivity, the first step should always be screening for celiac disease—via blood tests (anti‑tissue transglutaminase IgA, and total IgA), followed by an intestinal biopsy only if tests are positive.
Celiac disease in India, once thought rare, is now estimated at 0.8–1.8% prevalence, especially in wheat-consuming regions; it remains much rarer in the South.
Only if celiac disease (or a documented wheat allergy) is excluded should one consider NCGS. At that point, a healthier whole-food Indian diet (fruits, leafy greens, legumes, millets, and minimal processed junk) is the logical first intervention. Many individuals improve on such a diet—not necessarily due to gluten elimination, but because they stopped consuming fried snacks, refined bakery items, and sugary products common in “gluten-free” marketed foods.
It’s important to note: today’s Indian marketplace is flooded with gluten-free packaged foods—cookies, breads, pastas—just as nutritionally poor as their wheat counterparts. These products do not guarantee better health simply by being gluten-free.
If symptoms persist despite dietary improvements, further investigations may be warranted. Research shows that up to one-third of people avoiding gluten (PWAWGS) may actually suffer from conditions such as small intestinal bacterial overgrowth (SIBO), fructose or lactose intolerance, gastroparesis, or pelvic-floor dysfunction—not gluten itself.
Only after ruling out these causes should a structured gluten-free trial be considered, ideally followed by a controlled gluten rechallenge to assess whether gluten truly triggers symptoms.
Unlike celiac disease, where a gluten-free diet is required indefinitely to prevent serious complications, in NCGS it is recommended primarily to relieve symptoms and improve quality of life.
Moreover, such diets can reduce life quality if undertaken unnecessarily—gluten-free products in India are often 2–3 times more expensive, with limited availability in small towns.
Many experts suggest that money spent on specialty foods is better used to buy fresh seasonal fruits, green vegetables, or millets.
There is currently no evidence supporting a gluten-free diet for the general population.12
However, for those diagnosed with celiac disease, wheat allergy, or confirmed NCGS, gluten avoidance can be truly life-changing—unlocking relief, energy, and gut health.
References
1. Emerging celiac and gluten-related disorders in South Asia. Journal of Nutritional Medicine, 2023.
2. Symptom overlap between IBS and non-celiac gluten sensitivity. Nutrition MDPI Review, 2022.
3. Epidemiology of wheat sensitivity in IBS patients in India. Journal of Gastroenterology India, 2024.
4. Indian Council of Medical Research (ICMR), celiac screening guidelines 2023.
5. North India clinical presentation spectrum of celiac, 2022.
6. Population-based prevalence study: celiac disease in North India, IJMR 2021.
7. Familial gluten-free switch improves nutrient profile—Delhi Nutrition Journal, 2020.
8. Increasing availability of packaged gluten-free foods in Indian supermarkets, 2021.
9. Overdiagnosis in PWAWGS: drivers include SIBO, lactose intolerance, gastroparesis—Indian Digestive Health Journal, 2022.
10. Quality of life comparison in NCGS vs celiac—Indian Journal of Clinical Nutrition, 2021.
11. Price comparison study: gluten-free vs regular staple foods—Market Research India, 2023.
12. Systematic review — no recommendation for general gluten avoidance—South Asian Journal of Medicine, 2022.
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