Gluten Peptide
Optimal Result:
0 - 5 ng/g.
Fecal Gluten Peptide quantitatively evaluates the gluten immunogenic peptide in stool after recent ingestion (within 2 to 4 days). Results can guide practitioners to the source of "hidden" gluten exposures – allowing for increased adherence to a proper therapeutic diet.
Gluten Peptide is commonly present in stool. Gluten-containing grains (such as wheat, rye, barley, and oat*) are digested into their gliadin and glutenin subunits. A specific section of the gliadin protein, referred to as the 33-mer peptide, is resistant to digestion in the human gastrointestinal (GI) tract and functions as a significant immune trigger in certain individuals, including those with celiac disease (CD). Even in non-celiac gluten-sensitive (NCGS) individuals, the 33-mer protein can be antigenic, inducing food sensitivities and intestinal permeability (leaky gut). When intestinal permeability is present, this antigenic peptide can drive extra-intestinal symptoms – those presenting outside the GI tract – such as skin manifestations, headaches, behavioral symptoms, and more.
Lab Results Explained and Tracked
What does it mean if your Gluten Peptide result is too high?
The Fecal Gluten Peptide Add-On (Stool Gluten) is an accurate and noninvasive method that enables a direct, quantitative assessment of gluten consumption. The amount of gluten peptide detected in stool rises in proportion to the amount of gluten consumed. Thus, the test can be useful for monitoring occasional exposures or exposures that may be routine in a persons' lifestyle (even if they are unknown).
This test is a direct quantification of the 33-mer gliadin peptide present in stool samples. Because this peptide is highly resistant to human digestion, it can be accurately detected in a person's stool several days after consumption of gluten.
Currently, the only approach to managing celiac disease is to maintain a strict gluten-free (GF) diet for life. Additionally, as non-celiac gluten-related disorders are emerging more and more in literature and clinical practice, many people choose to be gluten-free to reduce GI inflammation and associated symptoms, and to prevent or heal intestinal permeability.
Although conceptually straight forward, there are inherent challenges to following a GF diet as recommended. Estimated compliance rates vary considerably (anywhere from 17–80%) depending on factors such as patient age, age of diagnosis, income, gender, and others. Celiac.org cites that up to 50% of celiac patients still report symptoms while following a GF diet. There are abundant opportunities for accidental exposure to gluten from hidden food sources and even medications. Food labeling and label reading is an added complication and a 2019 study found that up to 32% of restaurant-labeled GF foods can be cross contaminated.
The importance of monitoring a GF diet is obvious, however there are currently no clear guidelines for exploring adherence or assessing the outcome. Recent studies suggest that patients cannot rely on dietary best practices or even symptoms to understand if they have been exposed to gluten.
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