Uncertainty about the effects of gluten on people who don't have celiac disease, a serious autoimmune disease, but who identify as "gluten sensitive" or "gluten intolerant" is rampant among doctors, too. As more and more patients experiment on their own with a gluten-free diet, researchers are struggling to keep up with just how and why cutting out the gluten may be helping or hurting them.
But the gastroenterologists around the world who've been trying understand the gluten puzzle say they're increasingly convinced of two key things: One is that the number of people who are truly non-celiac gluten sensitive is probably very small. Second, they say that the people who say they feel better on a gluten-free diet are more likely sensitive to a specific kind of carbohydrate in the wheat — not the gluten protein.
That carbohydrate, called fructan, is a member of a group of carbs that gastroenterologists say is irritating the guts of a lot of people, causing gas, diarrhea, distention and other uncomfortable symptoms. Altogether, these carbs are called fermentable oligo-di-monosaccharides and polyols, or the cumbersome acronym FODMAPs.