headacheschronic headacheheadach
More serious causes of secondary headaches include: Gastrointestinal disorders may cause headaches, including Helicobacter pylori infection, celiac disease, non-celiac gluten sensitivity, irritable bowel syndrome, inflammatory bowel disease, gastroparesis, and hepatobiliary disorders. The treatment of the gastrointestinal disorders may lead to a remission or improvement of headaches. The brain itself is not sensitive to pain, because it lacks pain receptors. However, several areas of the head and neck do have pain receptors and can thus sense pain.

Tropical sprue

spruesprue, tropical
Folic acid deficiency, effects of malabsorbed fat on intestinal motility, and persistent small intestinal bacterial overgrowth may combine to cause the disorder. A link between small intestinal bacterial overgrowth and tropical sprue has been proposed to be involved in the aetiology of post-infectious IBS. Diagnosis of tropical sprue can be complicated because many diseases have similar symptoms. The following investigation results are suggestive: Tropical sprue is largely limited to within about 30 degrees north and south of the equator. Recent travel to this region is a key factor in diagnosing this disease in residents of countries outside of that geographical region.


Celiac disease. Non-celiac gluten sensitivity. Pyloric stenosis (in babies, this typically causes a very forceful "projectile vomiting" and is an indication for urgent surgery). Bowel obstruction. Overeating. Acute abdomen and/or peritonitis. Ileus. Food allergies (often in conjunction with hives or swelling). Cholecystitis, pancreatitis, appendicitis, hepatitis. Food poisoning. In children, it can be caused by an allergic reaction to cow's milk proteins (Milk allergy or lactose intolerance). Movement: motion sickness (which is caused by overstimulation of the labyrinthine canals of the ear). Ménière's disease. Concussion. Cerebral hemorrhage. Migraine.

Proton-pump inhibitor

proton pump inhibitorproton pump inhibitorsproton-pump inhibitors
Concerns have also been raised about spontaneous bacterial peritonitis in older people taking PPIs and in people with irritable bowel syndrome taking PPIs; both types of infections arise in these populations due to underlying conditions and it is not clear if this is a class effect of PPIs. PPIs may predispose an individual to developing small intestinal bacterial overgrowth or fungal overgrowth. Long-term use of PPIs is associated with the development of benign polyps from fundic glands (which is distinct from fundic gland polyposis); these polyps do not cause cancer and resolve when PPIs are discontinued. There is no association between PPI use and cancer or pre-cancer.


spelt crustT. speltaSpelt bread
Spelt contains gluten and is therefore suitable for baking, but this component also makes it unsuitable for people with gluten-related disorders, such as celiac disease, non-celiac gluten sensitivity, and wheat allergy. In comparison to hard red winter wheat, spelt has a more soluble protein matrix characterized by a higher gliadin:glutenin ratio. In Germany and Austria, spelt loaves and rolls (Dinkelbrot) are widely available in bakeries as is spelt flour in supermarkets. The unripe spelt grains are dried and eaten as Grünkern ("green grain"). Dutch Jenever makers distill with spelt.


six-row barleymalting barleypot barley
Like wheat, rye, and their hybrids and derivatives, barley contains gluten, which makes it an unsuitable grain for consumption by people with gluten-related disorders, such as celiac disease, non-celiac gluten sensitivity and wheat allergy sufferers, among others. Nevertheless, some wheat allergy patients can tolerate barley or rye. Barley is a key ingredient in beer and whisky production. Two-row barley is traditionally used in German and English beers. Six-row barley was traditionally used in US beers, but both varieties are in common usage now.


In the past, functional bowel disorders such as irritable bowel syndrome (IBS) that produced symptoms of bloating were attributed to increased production of intestinal gas. However, three significant pieces of evidence refute this theory. First, in normal subjects, even very high rates of gas infusion into the small intestine (30 ml/min) are tolerated without complaints of pain or bloating and harmlessly passed as flatus per rectum. Secondly, studies aiming to quantify the total volume of gas produced by IBS patients (some including gas emitted from the mouth by eructation) have consistently failed to demonstrate increased volumes compared to healthy subjects.


fibrositismuscular rheumatismfibromyalgia syndrome
The validity of fibromyalgia as a unique clinical entity is a matter of contention because "no discrete boundary separates syndromes such as FMS, chronic fatigue syndrome, irritable bowel syndrome, or chronic muscular headaches". Because of this symptomatic overlap, some researchers have proposed that fibromyalgia and other analogous syndromes be classified together as functional somatic syndromes for some purposes. Investigational medications include cannabinoids and the 5-HT3 receptor antagonist tropisetron. Low quality evidence found an improvement in symptoms with a gluten free diet among those without celiac disease.


allergiesallergicallergic reaction
Symptoms of food allergy include abdominal pain, bloating, vomiting, diarrhea, itchy skin, and swelling of the skin during hives. Food allergies rarely cause respiratory (asthmatic) reactions, or rhinitis. Insect stings, food, antibiotics, and certain medicines may produce a systemic allergic response that is also called anaphylaxis; multiple organ systems can be affected, including the digestive system, the respiratory system, and the circulatory system. Depending on the rate of severity, anaphylaxis can include skin reactions, bronchoconstriction, swelling, low blood pressure, coma, and death. This type of reaction can be triggered suddenly, or the onset can be delayed.

Gastrointestinal tract

intestinegastrointestinaldigestive tract
Different types of surgery and treatment managing life-threatening complications such as ileus and volvulus, intestinal stasis which lead to bacterial overgrowth, and resection of affected or dead parts of the gut may be needed. Many patients require parenteral nutrition. Ileus is a blockage of the intestines. Coeliac disease is a common form of malabsorption, affecting up to 1% of people of northern European descent. An autoimmune response is triggered in intestinal cells by digestion of gluten proteins. Ingestion of proteins found in wheat, barley and rye, causes villous atrophy in the small intestine.

Ulcerative colitis

colitis ulcerosainflammatory colitiscolitis
Mild abdominal pain or cramping may occur. Patients may believe they are constipated when in fact they are experiencing tenesmus, which is a constant feeling of the need to empty the bowel accompanied by involuntary straining efforts, pain, and cramping with little or no fecal output. Rectal pain is uncommon. Moderate disease correlates with more than four stools daily, but with minimal signs of toxicity. Patients may display anemia (not requiring transfusions), moderate abdominal pain, and low-grade fever, 38 to 39 C.


breadsbreadmakingbread making
Gluten-free breads have been created for people affected by gluten-related disorders such as coeliac disease and non-coeliac gluten sensitivity, who may benefit from a gluten-free diet. Gluten-free bread is made with ground flours from a variety of materials such as almonds, rice, sorghum, corn, or legumes such as beans, but since these flours lack gluten they may not hold their shape as they rise and their crumb may be dense with little aeration. Additives such as xanthan gum, guar gum, hydroxypropyl methylcellulose (HPMC), corn starch, or eggs are used to compensate for the lack of gluten.


lambliasisgiardiaacute giardiasis.
Some intestinal parasitic infections may play a role in irritable bowel syndrome and other long-term sequelae. In cats, giardiasis responds to metronidazole, although this should not be administered to pregnant cats as it can cause developmental malformations. An alternative and effective drug is febendazole. * Kathleen Meyer, How to Shit in the Woods: An Environmentally Sound Approach to a Lost Art, Ten Speed Press (1989).

Khorasan wheat

kamutkhorasanT. turanicum
As kamut contains gluten, it is unsuitable for people with gluten-related disorders, such as celiac disease, non-celiac gluten sensitivity and wheat allergy sufferers, among others. As Khorasan wheat is an ancient cereal species, the climatic requirements still correspond very well with its region of origin—i.e., the fertile crescent in the Middle East. A temperate continental climate with cold nights in the early spring (see vernalisation), low to moderate precipitation rates (500–1,000 mm per year), and a sunny warm summer for optimal ripening are therefore the typical preferred climatic conditions of Khorasan wheat.

Gluten challenge test

rechallengegluten challenge
There are indications that patients with non-coeliac gluten sensitivity show a reappearance of symptoms in far shorter time than is the case for coeliac disease: in non-coeliac gluten sensitivity, symptoms usually relapse in a few hours or days of gluten challenge. In cases of suspected coeliac disease, a gastrointernal biopsy is performed at the end of the gluten challenge. For an alternative diagnosis of non-coeliac gluten sensitivity, the reappearance of symptoms is assessed. However, there is no agreement so far as to how to perform a non-coeliac gluten sensitivity symptom evaluation after a gluten challenge.


These disorders include certain endocrine diseases (hypo- and hyperthyroidism, hyperprolactinemia), metabolic disorders (diabetes), deficiency states (low levels of vitamin D, B2, B12, folic acid), gastrointestinal diseases (celiac disease, non-celiac gluten sensitivity, inflammatory bowel disease), heart diseases, blood diseases (anemia), cerebral vascular accidents (transient ischemic attack, stroke), and brain degenerative diseases (Parkinson's disease, dementia, multiple sclerosis, Huntington's disease), among others. Several drugs can cause or worsen anxiety, whether in intoxication, withdrawal or from chronic use.

Intestinal mucosal barrier

GI mucosabarrier function of the intestinal mucosaintestinal barrier
Nevertheless, there is a growing body of evidence that implicates increased intestinal permeability as a primary etiologic factor of inflammatory bowel disease pathogenesis. Altered intestinal barrier function may play a role in the development of celiac disease. By allowing gliadin, the causative agent of celiac disease, to cross the intestinal barrier, inappropriate activation of the immune system can occur. Celiac disease sufferers have been shown to have elevated intestinal permeability and altered tight junctions. Moreover, these disruptions persist in patients who successfully maintain a gluten-free diet.

Eating disorder

eating disorderseatingeating behavior
It has been documented that some people with celiac disease, irritable bowel syndrome or inflammatory bowel disease who are not conscious about the importance of strictly following their diet, choose to consume their trigger foods to promote weight loss. On the other hand, individuals with good dietary management may develop anxiety, food aversion and eating disorders because of concerns around cross contamination of their foods.


duodenalduodenal tractearly part of the small intestine
Duodenal ulcers may cause recurrent abdominal pain and dyspepsia, and are often investigated using a urea breath test to test for the bacteria, and endoscopy to confirm ulceration and take a biopsy. If managed, these are often managed through antibiotics that aim to eradicate the bacteria, and PPIs and antacids to reduce the gastric acidity. The British Society of Gastroenterology (BSG) guidelines specify that a duodenal biopsy is required for the diagnosis of adult celiac disease. The biopsy is ideally performed at a moment when the patient is on a gluten-containing diet. Other causes of disease include: * Pancreas * Duodenum at the Human Protein Atlas Anterior. Gallbladder.

Anti-gliadin antibodies

anti-gliadin IgGAGAAntibodies to α-gliadin
It is also associated with coeliac disease and non-celiac gluten sensitivity. Anti-gliadin antibodies are frequently found with anti-transglutaminase antibodies. The IgE antibodies are more typically found in allergy-related conditions such as urticaria, asthma, and wheat-dependent exercise-induced anaphylaxis. The target of the most allergenic antibodies is ω-5 gliadin, which is encoded by the Gli-1B gene found on the B haplome (Aegilops speltoides derived) of wheat. What is the relationship of gluten and anti-gliadin antibodies?. In gluten-sensitive individuals AGA testing is a routinely used blood test for possible presence of coeliac disease, allergies or idiopathic phenomena.

Duodenal lymphocytosis

The list of possible causes is wide, including coeliac disease, environmental enteropathy (tropical sprue), autoimmune enteropathy, small intestinal bacterial overgrowth, NSAID damage, Helicobacter pylori, other infections and Crohn's disease. Diagnosis is made by accurate counting of intraepithelial lymphocytes during histological examination of the duodenum. The definition of the condition includes the requirement that the duodenal histological appearances are otherwise unremarkable, specifically with normal villous architecture. In coeliac disease (also known as gluten-sensitive enteropathy), duodenal lymphocytosis is found in untreated or partially treated cases.


triticale (× ''Triticosecale'')× ''Triticosecalequadrotriticale
Like both its hybrid parents – wheat and rye – triticale contains gluten and is therefore unsuitable for people with gluten-related disorders, such as celiac disease, non-celiac gluten sensitivity and wheat allergy sufferers, among others. An episode of the popular TV series Star Trek, "The Trouble With Tribbles", revolved around the protection of a grain developed from triticale, which writer David Gerrold called "quadro-triticale" at producer Gene Coon's suggestion, and to which he ascribed four distinct lobes per kernel.

Microscopic colitis

People may also experience abdominal pain, fecal incontinence, and unintentional weight loss. Microscopic colitis is the diagnosis in around 10% of cases investigated for chronic non-bloody diarrhea. A higher incidence of autoimmune diseases, for example arthritis, Sjögren's syndrome, thyroid disorders, and celiac disease, has been reported in people with microscopic colitis. Associations with various drugs have been found, especially proton pump inhibitors, H 2 blockers, selective serotonin reuptake inhibitors (SSRIs), and non-steroidal anti-inflammatory drugs (NSAIDs). Bile acid diarrhea is found in 41% of patients with collagenous colitis and 29% with lymphocytic colitis.


Gluten-related disorders: untreated celiac disease and non-celiac gluten sensitivity. Anemia can be the only manifestation of celiac disease, in absence of gastrointestinal or any other symptoms. Inflammatory bowel disease. Iron deficiency anemia is due to insufficient dietary intake or absorption of iron to meet the body's needs. Infants, toddlers, and pregnant women have higher than average needs. Increased iron intake is also needed to offset blood losses due to digestive tract issues, frequent blood donations, or heavy menstrual periods. Iron is an essential part of hemoglobin, and low iron levels result in decreased incorporation of hemoglobin into red blood cells.

Peripheral neuropathy

A 2008 literature review concluded that, "based on principles of evidence-based medicine and evaluations of methodology, there is only a 'possible' association [of celiac disease and peripheral neuropathy], due to lower levels of evidence and conflicting evidence. There is not yet convincing evidence of causality." Stem-cell therapy is also being looked at as a possible means to repair peripheral nerve damage. Urinary bladder conditions: bladder incontinence or urine retention. Gastrointestinal tract: dysphagia, abdominal pain, nausea, vomiting, malabsorption, fecal incontinence, gastroparesis, diarrhoea, constipation.