Nonceliac Wheat Sensitivity: Bridging Research, Clinical Experience, Uncertainties, and Future Perspective.

Area of Science:

• Gastroenterology and immunology
• Wheat-related disorders

Background:

• Nonceliac wheat sensitivity (NCWS) is a recognized condition.
• Its pathogenesis is not fully understood.
• Wheat components like FODMAPs and ATIs may trigger immune responses and symptoms in NCWS patients.

Purpose of the Study:

• To review the progress in understanding nonceliac wheat sensitivity.
• To outline the clinical and histological features of NCWS.
• To discuss current controversies and diagnostic challenges.

Main Methods:

• Literature review of studies on nonceliac wheat sensitivity over recent decades.
• Analysis of clinical and histological data.
• Examination of diagnostic criteria and controversies.

Main Results:

• NCWS involves reactions to multiple wheat constituents, not solely gluten.
• Diagnosis is complicated by the absence of a specific biomarker.
• Current diagnostic methods include exclusion of other disorders and double-blind placebo-controlled wheat challenges.

Conclusions:

• Further research is essential to refine diagnostic tools for NCWS.
• Improved therapeutic strategies are needed for patients with nonceliac wheat sensitivity.
• Understanding the complex triggers of NCWS is crucial for patient management.