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Non celiac gluten sensitivity and diagnostic challenges.

Giovanni Casella1, Vincenzo Villanacci2, Camillo Di Bella3

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Non-celiac gluten sensitivity (NCGS) causes intestinal and extra-intestinal symptoms. Diagnosis involves excluding other conditions and a gluten-free diet trial, as reliable markers are currently unavailable.

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Area of Science:

  • Gastroenterology
  • Clinical Medicine
  • Dietary Science

Background:

  • Non-celiac gluten sensitivity (NCGS) presents with diverse symptoms linked to gluten intake.
  • It is often confused with celiac disease and wheat allergy, necessitating differential diagnosis.
  • Prevalence estimates for NCGS range from 0.6% to 6%.

Purpose of the Study:

  • To review recent research advancements in non-celiac gluten sensitivity.
  • To provide a historical overview of NCGS for gastroenterologists.
  • To discuss diagnostic challenges and current understanding of NCGS.

Main Methods:

  • Literature review of academic databases (PubMed, Google Scholar).
  • Analysis of studies focusing on non-celiac gluten sensitivity and gluten-related disorders.
  • Synthesis of findings on diagnosis, mechanisms, and prevalence.

Main Results:

  • Diagnosis of NCGS requires exclusion of celiac disease and wheat allergy.
  • No reliable serological marker for NCGS is currently available.
  • A gluten-free diet followed by gluten challenge is the current diagnostic standard.
  • Histological findings in NCGS are variable, ranging from normal to mild inflammation.

Conclusions:

  • NCGS diagnosis relies on symptom response to gluten withdrawal and challenge.
  • Understanding the underlying mechanisms of NCGS requires further investigation.
  • The Salerno expert criteria aid research but have limited clinical application.