Should you avoid gluten if you have GI symptoms?

What’s the most common reason why people buy gluten-free foods? “No reason at all,” says one survey.

The respondents’ other reasons: they see gluten-free foods as a “healthier option,” good for “digestive health” or “weight loss,” or they “enjoy the taste.” Those reasons were all more common than “gluten sensitivity,” which was cited by only 8 percent.

But in a recent study, even GI symptoms like diarrhea or bloating weren’t a reliable sign of celiac disease, the autoimmune disorder that makes people unable to tolerate gluten, the protein in wheat, barley, rye, and some other grains.

What the researchers found

“Our study asked about abdominal pain, diarrhea, constipation, vomiting, weight loss, irritable bowel syndrome, dyspepsia, GERD, difficulty swallowing, bloating, and distention,” says Joseph Murray, a gastroenterologist and celiac expert at the Mayo Clinic. “None were significantly associated with having celiac disease.”

The study surveyed roughly 3,200 ordinary Minnesotans. “We were trying to find out where celiac disease is hiding in the community,” says Murray. Roughly 1 percent of people have celiac, but more than 80 percent of cases are undiagnosed.

Symptoms aren't enough to identify all people with celiac disease

“Unfortunately, we can’t use classic symptoms as a way to identify celiac patients,” says Murray. Whom would he test?

“I would test liberally—anyone with an iron deficiency or a family history,” he says. “If you have an immediate family member with celiac, tell your doctor.”

(Celiac can cause iron deficiency because it cripples the body’s ability to absorb some nutrients.)

Don’t try a gluten-free diet to see if you feel better before you get tested

“Once you go gluten-free, a blood test may not pick up celiac disease anymore,” cautions Murray.

The bottom line: GI symptoms don’t mean that you have celiac disease, and no symptoms doesn’t mean you don’t.