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

Best Pract Res Clin Gastroenterol. 2015 Jun;29(3):477-91. doi: 10.1016/j.bpg.2015.04.006. Epub 2015 May 9.


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.

Keywords: Anti-gliadin antibodies; Celiac disease; Duodenal biopsy; Innate/adaptive immunity; Irritable bowel syndrome; Wheat allergy.

Publication types

  • Review

MeSH terms

  • Celiac Disease / diagnosis
  • Humans
  • Wheat Hypersensitivity* / diagnosis
  • Wheat Hypersensitivity* / epidemiology
  • Wheat Hypersensitivity* / immunology