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Gluten Sensitivity.

Carlo Catassi1

  • 1Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy.

Annals of Nutrition & Metabolism
|November 26, 2015
PubMed
Summary
This summary is machine-generated.

Non-celiac gluten sensitivity (NCGS) involves gluten-related symptoms in individuals without celiac disease or wheat allergy. Diagnosis requires a double-blind, placebo-controlled gluten challenge to confirm the gluten-symptom link.

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Area of Science:

  • Gastroenterology
  • Immunology
  • Neurology

Background:

  • Non-celiac gluten sensitivity (NCGS) presents with diverse gastrointestinal and systemic symptoms triggered by gluten ingestion.
  • NCGS affects individuals negative for celiac disease (CD) and wheat allergy (WA), with prevalence estimates suggesting it may be more common than CD.
  • Symptoms can manifest as irritable bowel syndrome-like issues, fatigue, headaches, and neurological/psychiatric disorders, impacting quality of life.

Purpose of the Study:

  • To define the characteristics and diagnostic criteria for non-celiac gluten sensitivity (NCGS).
  • To differentiate NCGS from celiac disease (CD) and wheat allergy (WA).
  • To highlight the current diagnostic gold standard for NCGS.

Main Methods:

  • Review of existing literature on NCGS diagnosis and symptomatology.
  • Exclusion of celiac disease (CD) and wheat allergy (WA) through serological testing.
  • Standardized double-blind, placebo-controlled gluten challenge to establish causality.

Main Results:

  • NCGS is characterized by symptom onset following gluten ingestion, relief upon withdrawal, and recurrence upon re-challenge.
  • A wide spectrum of symptoms, including gastrointestinal, neurological, and psychiatric manifestations, are associated with NCGS.
  • No specific biomarker currently exists for NCGS diagnosis.

Conclusions:

  • NCGS diagnosis relies on a confirmed cause-effect relationship between gluten and symptoms via a controlled challenge.
  • NCGS should not be solely an exclusion diagnosis, emphasizing the need for positive confirmation.
  • Further research is needed to identify reliable biomarkers for NCGS.