Many Unanswered Questions on Gluten Sensitivity
It's possible that gluten sensitivity and celiac disease represent different aspects of the same condition. It's also possible that they represent completely separate conditions, with completely different causes.
Since researchers don't yet agree on a definition for gluten sensitivity, they can't say for sure why it may occur and how it might relate to celiac disease.
At least one academic researcher believes they're separate conditions, but others in the celiac/gluten-sensitive community believe that they may be different facets of the same condition, or that gluten sensitivity might simply represent early celiac disease.
In addition, it's likely that not everyone who avoids gluten needs to do so. If you drop gluten from your diet and feel better, you may be sensitive or intolerant to it. But there may be other explanations for your health turnaround.
Some people may feel better simply because they're eating a healthier diet -- by cutting out gluten, you're also cutting out many forms of processed and junk foods. In fact, this is part of the reasoning behind increasingly popular "gluten-free cleanse" diets promoted by Oprah Winfrey and other celebrities (read more on whether going gluten-free can help you lose weight here: Gluten-Free Weight Loss).
It's also possible that you feel better simply because you feel you're doing something positive for your health, i.e., feeling better on the gluten-free diet represents the placebo effect in action.
I don't say this lightly -- in the past, too many physicians downplayed and dismissed potential symptoms from gluten, and the "it's all in your head" mantra still persists in some parts of the medical community, despite advances in awareness.
But it's true that some people who believe they can't tolerate gluten may be able to tolerate it just fine... as evidenced by the fact that some people who say they're gluten-sensitive can "cheat" on the diet without clear symptoms.
More on how big the gluten-sensitive population might be:
Gluten Sensitivity Treatment: The Gluten-Free Diet
As with celiac disease, the only current treatment for gluten sensitivity is the gluten-free diet.
There's quite a lot of debate over how strict that diet needs to be for someone who may "only" be gluten-sensitive. Some physicians will tell you to go ahead and cheat on occasion, while others will recommend a very strict gluten-free diet.
It's not clear whether following a gluten-free diet can provide you with health benefits beyond those you get from simply feeling better. As I said earlier, there's been little research indicating that you experience physical damage from gluten (no matter how unpleasant the symptoms might be). But there's also been no research showing that you don't experience damage — this is an area that researchers are just beginning to explore.
More on other health conditions associated with gluten sensitivity:
As with everything involving gluten sensitivity, there are only a few studies that provide any insight. Eventually, scientists hope to provide more answers. In the meantime, you may need to decide for yourself — in consultation with your physician — how strictly to follow the gluten-free diet.
J. Biesiekierski et al. Gluten Causes Gastrointestinal Symptoms in Subjects Without Celiac Disease: A Double-Blind Randomized Placebo-Controlled Trial. American Journal of Gastroenterology. Published online Jan. 11, 2011. doi: 10.1038/ajg.2010.487.
A. Fasano et al. Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity. BMC Medicine 2011, 9:23. doi:10.1186/1741-7015-9-23.
Fasano A. et. al. Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Medicine. BMC Medicine 2012, 10:13 doi:10.1186/1741-7015-10-13. Published: 7 February 2012