The role of gluten, milk, and other dietary proteins in chronic or intermittent dyspepsia

Summary In twenty‐seven patients with chronic or intermittent dyspepsia raised levels of the gamma‐M‐globulin and of the α1‐ and of the α2‐globulin were encountered. Malabsorption, present in about three‐quarters of the cases, was usually mild. Various degrees of villous abnormalities were seen but no flat mucosa. Eight patients also had dermatitis. During dietary treatment with the elimination of gluten, milk, or other food elements the dyspepsia and the malabsorption subsided in all but two, and the dermatitis in all but one. In nearly all the investigated cases the raised levels of the gamma‐M‐globulin and of the α1‐ and of the α2‐globulin decreased. During challenge feeding with the offending food the dyspepsia and the dermatitis reappeared. Also the faecal fat excretion increased again, and a rise was noticed in the α1‐ and in the α2‐globulins and in the gamma‐M‐globulins. The findings suggest that gluten, milk and other dietary proteins may play a role in some chronic dyspepsias by exerting an antigenic stimulus on the small intestinal mucosa, and thus inducing a state of hypersensitivity towards these foods. The clinical and laboratory findings favour the view that the condition is different from coeliac disease