With wheat sensitivity, patients can help gluten-free

Although gluten is not the cause of wheat sensitivity, a gluten-free diet helps
People who suffer from symptoms such as abdominal pain, diarrhea and constipation, flatulence, nausea, loss of appetite and weight loss despite adequate caloric intake may be affected by celiac disease or a wheat allergy. But there is also a so-called wheat sensitivity as a cause in question, which is less well known. This is indicated by the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS). A gluten-free diet also helps with this form, although gluten is not the cause of the disorder in this case.

In wheat sensitivity sufferers also suffer from complaints outside the gastrointestinal tract
For more than 90 percent of the population, the consumption of wheat and wheat products is harmless, reports the DGVS. The rest suffers from sometimes severe indigestion after wheat-containing meals. If a clear improvement in the symptoms occurs as a result of a gluten-free diet, the cause is not always a gluten allergy (celiac disease) or a wheat allergy. The indigestion can also be due to a wheat sensitivity.

More and more people are sensitive to wheat products. (Image: Africa Studio / fotolia.com)

"Amylase trypsin inhibitors, ATIs for short, are natural proteins in cereals that activate certain cells of the innate immune system," explains Detlef Schuppan, head of the Institute of Translational Immunology and Outpatient Clinic for Celiac Diseases and Small Bowel Diseases at Mainz University Hospital. In people with wheat sensitivity, the released inflammatory agents sometimes cause abdominal pain and diarrhea. In a special issue of the journal "Gastroenterology" Schuppan and his colleagues report that, in particular, complaints can occur outside the gastrointestinal tract, such as headaches, migraines, chronic fatigue and muscle and joint pain. Especially people with already existing chronic inflammation or autoimmune diseases could therefore strongly suffer from a wheat sensitivity. "In animal studies, ATIs potentiate inflammatory and autoimmune reactions by activating innate immune cells," says the physician and biochemist. It all points to the fact that symptoms of diseases such as multiple sclerosis or a chronic inflammatory bowel disease made worse by these wheat proteins.

If wheat sensitivity is suspected, thorough diagnosis should be made
"People who suspect that they can not tolerate wheat, rye or barley, should undergo a thorough diagnosis," the DGVS advises in a statement. "At present, the diagnosis of wheat sensitivity is based on the exclusion principle: if physicians can rule out celiac disease, wheat allergy and certain other diseases as the cause of the symptoms, wheat sensitivity is likely."

All three patient groups benefit from a gluten-free diet, although the cause of their complaints is due to different ingredients in the wheat. By avoiding gluten, people with wheat sensitivity also avoid the ATIs that cause them problems. "Unlike celiac disease, a wheat diet does not require a strict diet," says Schuppan. It is usually sufficient to reduce the gluten- and thus ATI-containing products by about 90 percent.

ATIs fulfill a protective function against pests for the plant. The cereals differ in some cases considerably in the amount of ATIs. Why this is so and whether this is controllable by the cultivation methods, is still being researched.

According to Schuppan, the diagnosis of wheat sensitivity may become simpler in the future: "We are hoping for a serum test that is currently under development." (Ag)