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Jessica R Biesiekierski1, Daisy Jonkers2, Carolina Ciacci3

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La sensibilidad al gluten no celíaca (NCGS) es una condición en la que las personas experimentan síntomas después de comer gluten, pero sin enfermedad celíaca o alergia al trigo. La investigación sugiere que los carbohidratos fermentables y los factores psicológicos contribuyen significativamente a los síntomas, lo que complica el diagnóstico.

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Área de la Ciencia:

  • Gastroenterología
  • Nutrición clínica
  • Las dietas

Sus antecedentes:

  • La sensibilidad al gluten no celíaca (NCGS) afecta a las personas que informan síntomas de la ingestión de gluten o trigo, distintos de la enfermedad celíaca o la alergia al trigo.
  • Mientras que el ~ 10% de los adultos informan de sensibilidad al gluten, los estudios controlados muestran que el 16-30% tiene desencadenantes específicos del gluten, aunque la metodología es variable.
  • Los carbohidratos fermentables y los efectos nocebo están implicados en la generación de síntomas, junto con las influencias comerciales y de los medios de comunicación en la investigación y la percepción.

Objetivo del estudio:

  • Revisar críticamente las pruebas actuales sobre el NCGS como una entidad distinta.
  • Para explorar los posibles mecanismos subyacentes a los síntomas de la GNC.
  • Proporcionar orientación práctica para la evaluación y la gestión de los SGNC.

Principales métodos:

  • Revisión sistemática de la literatura existente sobre las NCGS.
  • Análisis de los desafíos de diagnóstico, incluida la falta de biomarcadores y la superposición con trastornos de interacción intestino-cerebro.
  • Evaluación de las metodologías de evaluación alimentaria y sus limitaciones.

Principales resultados:

  • El diagnóstico definitivo de NCGS es difícil debido a la ausencia de biomarcadores y la variabilidad metodológica.
  • Los carbohidratos fermentables y los efectos nocebo juegan un papel considerable en el desarrollo de los síntomas.
  • El NCGS sigue siendo un diagnóstico de exclusión que requiere una evaluación cuidadosa.

Conclusiones:

  • El diagnóstico de NCGS es elusivo, lo que requiere un enfoque sistemático que equilibre los cambios en la dieta con los factores psicológicos y la adecuación nutricional.
  • Se necesita más investigación para identificar los agentes causantes y desarrollar pruebas de diagnóstico.
  • La gestión requiere reconocer las incertidumbres y centrarse en la atención individualizada.