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Think you're gluten intolerant? Chances are you're not say experts as they identify REAL reason for painful bloating and abdominal cramps READ MORE: When to worry about flatulence - when it could be a sign of cancer By ZOE HARDY, HEALTH REPORTER Published: 12:54 GMT, 27 October 2025 | Updated: 12:56 GMT, 27 October 2025 Not everyone who experiences painful bloating and abdominal cramps may be sensitive to gluten, despite numerous studies identifying it as a potential trigger. Wellness influencers, athletes and even some nutritionists have turned gluten—the protein in wheat, rye and barley—into a dietary villain, and it's now avoided by over eight per cent of Britons for 'health' reasons. But in a review examining decades of research, scientists have revealed that for most people who experience common symptoms including diarrhoea, abdominal pain and bloating, gluten is rarely the trigger. Around one in 100 people in the UK are thought to suffer coeliac disease, when the immune system overreacts to gluten, causing a number of debilitating symptoms. Over time, damage accumulates in the gut, often leading to serious nutrient deficiencies and nerve damage. However, many people will experience painful gut symptoms after eating foods containing gluten, but test negative for the disease or a wheat allergy. These people are said to have non-coeliac gluten sensitivity, but until now it has remained unclear whether gluten itself, or other factors, trigger symptoms. In the study, published in the journal The Lancet, researchers analysed more than 58 studies which looked at changes to the immune system, gut barrier, gut microbiome and possible psychological explanations for a perceived gluten sensitivity. Researchers now say most gluten sensitivity isn't actually about gluten, with other culprits such as FODMAPs causing painful bloating and abdominal cramps Around one in 100 people in the UK suffer coeliac disease, whereby the immune system overreacts to gluten The researchers found that gluten-specific reactions were rare, and when they did occur changes in symptoms were relatively minor. One landmark study included in the review looked at the role of fermentable carbohydrates—known as FODMAPs, fermentable oligosaccharides, disaccharides, monosaccharides and polyols—notorious for triggering digestive symptoms. These carbohydrates can't be broken down by the small intestine, and instead move slowly through the digestive tract attracting water until they're fermented by microbes in the large intestine, producing gas. Results showed that when participants switched to a low FODMAP diet, avoiding foods like onion, garlic, certain fruits such as apples and nectarines and cereals, their symptoms improved, even when gluten was reintroduced. Another study found that fructans, a type of FODMAP found in wheat, onion and garlic, caused more painful and extreme bloating than gluten itself. This, the researchers concluded, suggests that most people who feel unwell after eating gluten are actually reacting to something else, such as FODMAPs or other wheat proteins rather than gluten itself. Another possible explanation for this reaction could reflect a problem with how the gut communicates with the brain—known as the gut brain axis. A consistent finding is how expecting to have symptoms can exacerbate patients' symptoms. Research has long suggested that activity in the gut can impact the brain What is coeliac disease? Coeliac disease is a genetic autoimmune disorder in which gluten leads to damage in the small intestine. Gluten provokes inflammation in the small intestine which affects the body's ability to absorb nutrients from food. The condition is estimated to affect one in 100 people worldwide. One percent - or three million Americans - are living with coeliac disease. There are more than 200 symptoms of coeliac disease but the more common ones are: Abdominal bloating and pain Chronic diarrhea Constipation Pale, foul-smelling, or fatty stool Weight loss The only treatment for the disease is a strict gluten-free diet. Only foods and beverages with a gluten content less than 20 parts per million are allowed. Source: Celiac Disease Foundation Advertisement In blinded trials, when participants unknowingly ate gluten there was almost no significant difference in the worsening of symptoms. In some cases, participants actually experienced worse symptoms after eating the gluten-free placebo—indicating that belief and prior experience can influence how the brain processes signals from the gut. Brain scans support this hypothesis, showing that feelings of anxiety can activate brain regions responsible for perceiving threats, which can in turn heighten sensitivity to normal gut processes so much so that normal digestive sensations are experienced as pain or urgency. This mechanism, researchers believe, could perpetuate the belief that individual's are sensitive to gluten when they are not—with diet changes to cut out gluten often encouraging mindful eating, which may further support gut health. However, other experts have said that this belief-driven behaviour could perpetuate symptoms of IBS, leading to malnutrition and other digestive issues because gluten-free foods typically contain more fat, salt, and sugar and less gut-friendly fibre and protein. Whilst the researchers acknowledged that for the one per cent of the population who suffer coeliac disease avoiding gluten is imperative, for others it may be an unnecessary precaution that is actually taking a toll on their gut health. Experts have long suggested that psychological counselling should be incorporated into treatment plans for patients suffering from debilitating gut issues, with new research suggesting this approach is more effective than once thought. After looking through 67 randomised controlled trials, involving more than 7,000 participants, researchers at the University of Leeds found that cognitive behavioural therapy (CBT) was more effective than standard treatments, based on the participants comparing their symptoms before and after. The researchers concluded that this integrated model could help move beyond the reductionist narrative that 'gluten is bad' and towards a more personalised treatment approach, helping patients safely reintroduce gluten into their diet. Share or comment on this article: Think you're gluten intolerant? Chances are you're not say experts as they identify REAL reason for painful bloating and abdominal cramps Add comment
