Stomach pain due to gluten is sometimes in your head · Health and Science

Where does this news come from?

Gluten hypersensitivity is already present and leads to serious gastroenteritis or celiac disease. This disease affects approximately 1 in 50 to 1 in 200 people, many of whom have no complaints. If we count only people who suffer from intestinal complaints, the number is lower. Celiac disease is diagnosed on the basis of a bowel biopsy. The only possible treatment is a low-gluten or gluten-free diet.

However, many people believe that they cannot tolerate gluten and that this is the cause of their gastrointestinal complaints, even if they do not have celiac disease. They also feel that their complaints decrease once they eat a low-gluten diet (1). Researchers investigated why this happens. They found 80 people with gluten hypersensitivity, who had ruled out celiac disease, and were willing to participate. The participants were divided into four groups. People who thought they were eating gluten reported fewer gastrointestinal complaints, while people who thought they were eating something without gluten reported significantly fewer complaints. In fact, half of each group was fed gluten and the other half was gluten-free. It turned out in all participating groups that people’s expectations played a decisive role in whether they suffered from gastrointestinal complaints or not. Anyone who expects negative effects after eating gluten will actually experience them, even if it turns out later that they did not eat gluten. This is called the nocebo effect.



How should you interpret this news?

Gluten is a protein found in various grains. Gluten is processed into bread, pastries, pasta, couscous, etc., and can also be found in processed and pre-packaged products, such as sauces, bouillon cubes, prepared meats, baked products, biscuits, milk desserts, etc. Gluten provides a glue-like structure.

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Over the past ten years, this protein has been the scapegoat for many stomach complaints. Gluten owes this negative image to the ominous media reports following the international bestseller Broodbuik (Wheat Belly) by William Davis and the gluten-free diet books by famous American author Gwyneth Paltrow, among others. They both suggested gluten as the cause of a whole host of chronic, vague complaints, and so it started.

As a result, more and more people with vague stomach complaints are automatically avoiding gluten. When these people eat gluten, they actually experience abdominal pain, even when they think they are eating gluten when that is not the case. This effect is called the “nocebo effect,” which is the opposite of the “placebo effect.” Stomach complaints are indeed real, but the cause has nothing to do with gluten. The expectation that something will happen will cause intestinal complaints affects the intestines and causes intestinal complaints. The brain and gut are closely linked. Exactly how this works has not yet been fully clarified.


Anyone who is gluten intolerant and eats gluten will have problems with the intestinal mucosa and sometimes gastrointestinal complaints as well. This condition is called celiac disease and the diagnosis can be made using an intestinal biopsy. Celiac disease is treated with a low-gluten diet. In addition, some people avoid gluten if they have intestinal complaints, believing that they also have a severe sensitivity to it, when upon examination it appears that they do not have celiac disease. However, they develop gastrointestinal complaints when they think they are eating something containing gluten, and they feel better when they avoid gluten. This is clear from new research. The complaints are actually real. The reason is between the ears.

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(2) De Graaf C, Lawton C, Cruden F et al. The effect of expectancy versus actual gluten intake on gastrointestinal and extraintestinal symptoms in non-celiac gluten sensitivity: a randomized, double-blind, international, placebo-controlled, multicenter study. Lancet Gastroenterol Hepatol 2023; November 28

Megan Vasquez

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