Non-celiac gluten sensitivity: a work-in-progress entity in the spectrum of wheat-related disorders.

Umberto Volta, Giacomo Caio, Roberto De Giorgio, Christine Henriksen, Gry Skodje, Knut E Lundin

Journal: Best practice & research. Clinical gastroenterology 2016;29(3):477-91

PMID: 26060112

Full Text on Elsevier Science View on PubMed

Abstract

Non-celiac gluten sensitivity is an undefined syndrome with gastrointestinal and extra-intestinal manifestations triggered by gluten in patients without celiac disease and wheat allergy. The pathogenesis involves immune-mediated mechanisms requiring further research. Symptoms disappear in a few hours or days after gluten withdrawal and recur rapidly after gluten ingestion. Besides gluten, other wheat proteins as well as fermentable oligo-, di-, mono-saccharides and polyols (FODMAPs) may contribute to this syndrome. This syndrome occurs mainly in young women, being rare in children. Its prevalence ranges from 0.6% to 6%, based on primary or tertiary care center estimates. No biomarker is available, but half of patients tests positive for IgG anti-gliadin antibodies, which disappear quickly after gluten-free diet together with symptoms. Also, genetic markers are still undefined. Although currently limited to a research setting, double-blind, placebo-controlled, cross-over trial strategy is recommended to confirm the diagnosis. Treatment is based on dietary restriction with special care to nutrient intake.

Address: Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. Electronic address: [email protected].; Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. Electronic address: [email protected].; Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. Electronic address: [email protected].; Department of Nutrition, University of Oslo, Oslo, Norway. Electronic address: [email protected].; Department of Gastroenterology, Oslo University Hospital Rikshospitalet, Oslo, Norway. Electronic address: [email protected].; Department of Gastroenterology, Oslo University Hospital Rikshospitalet, Oslo, Norway; Centre for Immune Regulation, University of Oslo, Oslo, Norway. Electronic address: [email protected].

DOI: 10.1016/j.bpg.2015.04.006

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MeSH Terms: Celiac Disease, Humans, Wheat Hypersensitivity