Journal List > Korean J Gastroenterol > v.75(1) > 1142217

Cha and Kim: Non-celiac Gluten Sensitivity

Abstract

Non-celiac gluten sensitivity (NCGS) is a term that is used to describe individuals who are not affected by celiac disease or wheat allergy, yet they have intestinal and/or extra-intestinal symptoms related to gluten ingestion with improvement of their symptoms upon withdrawing gluten from their diet. Gluten-related disorder groups are manifested by symptoms of gastrointestinal tract disorders, as well as hematological dermatological endocrinological, gynecological, rheumatological and nervous system symptoms. It is believed that NCGS represents heterogeneous groups with different subgroups characterized by different etiologies, clinical histories and clinical courses. There also appears to be an overlap between NCGS and irritable bowel syndrome (IBS). There is a need for establishing strict criteria for diagnosing NCGS. The absence of validated biomarkers remains a significant limitation for research studies on NCGS. New evidence shows that a gluten-free diet may be beneficial for some patients with gastrointestinal symptoms, such as those symptoms commonly found in patients with IBS. Further studies about NCGS are needed.

Figures and Tables

Fig. 1

Celiac disease and gluten-related disorders. WDEIA, wheat-dependent exercise-induced anaphylaxis.

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Fig. 2

Salerno diagnosis algorithm of non-celiac gluten sensitivity. GFD, gluten free diet; A, product A (gluten or placebo); B, product B (placebo or gluten); E, evaluation (questionnaire); NCGS, non-celiac gluten sensitivity.

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Fig. 3

Correlation of non-celiac gluten sensitivity and irritable bowel syndrome.

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Table 1

Clinical Symptoms of Non-celiac Gluten Sensitivity

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Notes

Financial support None.

Conflict of interest None.

References

1. Wieser H. Chemistry of gluten proteins. Food Microbiol. 2007; 24:115–119.
crossref pmid
2. Fasano A, Sapone A, Zevallos V, Schuppan D. Nonceliac gluten sensitivity. Gastroenterology. 2015; 148:1195–1204.
crossref pmid
3. Di Sabatino A, Corazza GR. Coeliac disease. Lancet. 2009; 373:1480–1493.
crossref pmid
4. Lebwohl B, Sanders DS, Green PHR. Coeliac disease. Lancet. 2018; 391:70–81.
crossref pmid
5. Gweon TG, Lim CH, Byeon SW, et al. A case of celiac disease. Korean J Gastroenterol. 2013; 61:338–342.
crossref pmid
6. Molina-Infante J, Santolaria S, Sanders DS, Fernández-Bañares F. Systematic review: noncoeliac gluten sensitivity. Aliment Pharmacol Ther. 2015; 41:807–820.
crossref pmid
7. Catassi C, Elli L, Bonaz B, et al. Diagnosis of non-celiac gluten sensitivity (NCGS): the Salerno experts' criteria. Nutrients. 2015; 7:4966–4977.
crossref pmid pmc
8. Ellis A, Linaker BD. Non-coeliac gluten sensitivity? Lancet. 1978; 1:1358–1359.
9. Jonas A. Wheat-sensitive--but not coeliac. Lancet. 1978; 2:1047.
10. Sapone A, Lammers KM, Mazzarella G, et al. Differential mucosal IL-17 expression in two gliadin-induced disorders: gluten sensitivity and the autoimmune enteropathy celiac disease. Int Arch Allergy Immunol. 2010; 152:75–80.
crossref
11. DiGiacomo DV, Tennyson CA, Green PH, Demmer RT. Prevalence of gluten-free diet adherence among individuals without celiac disease in the USA: results from the Continuous National Health and Nutrition Examination Survey 2009-2010. Scand J Gastroenterol. 2013; 48:921–925.
crossref pmid
12. Lee HJ, Kim HJ, Kang EH, et al. Self-reported food intolerance in Korean patients with irritable bowel syndrome. J Neurogastroenterol Motil. 2019; 25:222–232.
crossref pmid pmc
13. Sapone A, Lammers KM, Casolaro V, et al. Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity. BMC Med. 2011; 9:23.
crossref pmid pmc
14. Volta U, Tovoli F, Cicola R, et al. Serological tests in gluten sensitivity (nonceliac gluten intolerance). J Clin Gastroenterol. 2012; 46:680–685.
crossref pmid
15. Caio G, Volta U, Tovoli F, D Giorgioe R. Effect of gluten free diet on immune response to gliadin in patients with non-celiac gluten sensitivity. BMC Gastroenterol. 2014; 14:26.
crossref pmid pmc
16. Carroccio A, Giambalvo O, Blasca F, Iacobucci R, D'Alcamo A, Mansueto P. Self-reported non-celiac wheat sensitivity in high school students: demographic and clinical characteristics. Nutrients. 2017; 9:E771.
crossref
17. Czaja-Bulsa G. Non coeliac gluten sensitivity - a new disease with gluten intolerance. Clin Nutr. 2015; 34:189–194.
crossref pmid
18. Aziz I, Hadjivassiliou M, Sanders DS. The spectrum of noncoeliac gluten sensitivity. Nat Rev Gastroenterol Hepatol. 2015; 12:516–526.
crossref pmid
19. Catassi C, Bai JC, Bonaz B, et al. Non-celiac gluten sensitivity: the new frontier of gluten related disorders. Nutrients. 2013; 5:3839–3853.
crossref pmid pmc
20. Catassi C, Alaedini A, Bojarski C, et al. The overlapping area of non-celiac gluten sensitivity (NCGS) and wheat-sensitive irritable bowel syndrome (IBS): an update. Nutrients. 2017; 9:E1268.
crossref
21. Vazquez-Roque MI, Camilleri M, Smyrk T, et al. A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea: effects on bowel frequency and intestinal function. Gastroenterology. 2013; 144:903–911.e3.
crossref pmid pmc
22. Vazquez-Roque MI, Camilleri M, Carlson P, et al. HLA-DQ genotype is associated with accelerated small bowel transit in patients with diarrhea-predominant irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2011; 23:481–487.
crossref pmid pmc
23. Staudacher HM, Lomer MC, Anderson JL, et al. Fermentable carbohydrate restriction reduces luminal bifidobacteria and gastrointestinal symptoms in patients with irritable bowel syndrome. J Nutr. 2012; 142:1510–1518.
crossref pmid
24. Volta U, Pinto-Sanchez MI, Boschetti E, Caio G, De Giorgio R, Verdu EF. Dietary triggers in irritable bowel syndrome: is there a role for gluten? J Neurogastroenterol Motil. 2016; 22:547–557.
crossref pmid pmc
25. Diez-Sampedro A, Olenick M, Maltseva T, Flowers M. A gluten-free diet, not an appropriate choice without a medical diagnosis. J Nutr Metab. 2019; 2019:2438934.
crossref
26. Niland B, Cash BD. Health benefits and adverse effects of a gluten-free diet in non-celiac disease patients. Gastroenterol Hepatol (N Y). 2018; 14:82–91.
pmid pmc
27. Stevens L, Rashid M. Gluten-free and regular foods: a cost comparison. Can J Diet Pract Res. 2008; 69:147–150.
crossref pmid
28. Zarkadas M, Cranney A, Case S, et al. The impact of a gluten-free diet on adults with coeliac disease: results of a national survey. J Hum Nutr Diet. 2006; 19:41–49.
crossref pmid
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Hyun Jin Kim
https://orcid.org/0000-0003-3853-0229

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