The patients weren't crazy—Knut Lundin was sure of that. But their ailment was a mystery. They were convinced gluten was making them sick. Yet they didn't have celiac disease, an autoimmune reaction to that often-villainized tangle of proteins in wheat, barley, and rye. And they tested negative for a wheat allergy. They occupied a medical no man's land.
About a decade ago, gastroenterologists like Lundin, based at the University of Oslo, came across more and more of those enigmatic cases. "I worked with celiac disease and gluten for so many years," he says, "and then came this wave." Gluten-free choices began appearing on restaurant menus and creeping onto grocery store shelves. By 2014, in the United States alone, an estimated 3 million people without celiac disease had sworn off gluten. It was easy to assume that people claiming to be "gluten sensitive" had just been roped into a food fad.
"Generally, the reaction of the gastroenterologist [was] to say, ‘You don't have celiac disease or wheat allergy. Goodbye,’" says Armin Alaedini, an immunologist at Columbia University. "A lot of people thought this is perhaps due to some other [food] sensitivity, or it's in people's heads."
But a small community of researchers started searching for a link between wheat components and patients' symptoms—commonly abdominal pain, bloating, and diarrhea, and sometimes headaches, fatigue, rashes, and joint pain. That wheat really can make nonceliac patients sick is now widely accepted.
