[Non-celiac gluten sensitivity: a critical review of current evidence]

Abstract

Non-celiac gluten sensitivity (NCGS) is an emerging disorder characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food in non-celiac patients. Its prevalence has been estimated to be six to ten-times higher than that of celiac disease (CD). A gluten-free diet is the most widely recommended therapy, but the causative agent remains unknown and there are no consensus diagnostic criteria. Recent studies on NCGS have included patients with possibly overlooked minor CD and diarrhea-predominant irritable bowel syndrome without self-reported gluten intolerance, but showing a response to a gluten-free diet. Furthermore, FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) have recently been postulated as the culprit component for NCGS in wheat, instead of gluten. This review updates evidence on the pathophysiology of NCGS and the efficacy of different dietary interventions in its treatment, stressing the need for proper screening for CD before a diagnosis of NCGS is made.

Keywords: Celiac disease; Dieta sin gluten; Enfermedad celiaca; FODMAP; FODMAP: oligo, di y monosacáridos fermentables y polioles; Gluten-free diet; Irritable bowel syndrome; Non-celiac gluten sensitivity; Sensibilidad al gluten no celiaca; Sindrome del intestino irritable; Trigo; Wheat.