Wheat-related disorders reviewed: making a grain of sense

Expert Rev Gastroenterol Hepatol. 2015 Jun;9(6):851-64. doi: 10.1586/17474124.2015.1032252. Epub 2015 Apr 3.

Abstract

Wheat-related disorders have become a growing area of clinical and scientific interest and can be categorized broadly as: autoimmune-mediated; allergic; and non-autoimmune/non-allergic conditions. Non-celiac gluten sensitivity (NCGS) and non-celiac wheat sensitivity (NCWS) present on this spectrum as disorders associated with adverse gastrointestinal and extra-intestinal manifestations following exposure to gluten and/or other wheat-related constituents. NCGS/NCWS is increasingly considered in patients with unexplained symptoms after the exclusions of celiac disease and wheat allergy. As objective diagnostic data and specific biomarkers are lacking, response to a gluten-free/wheat-free diet can confirm the presence of NCGS/NCWS. An association with irritable bowel syndrome has been detected, and the effects of other food components, such as fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, may contribute. Our organization and synthesis of extant knowledge pertaining to wheat-related disorders may advance current practice and research efforts toward an improved understanding of NCGS/NCWS as an evolving clinical entity.

Keywords: gluten intolerance; gluten-free diet; non-celiac gluten sensitivity; wheat allergy; wheat sensitivity.

MeSH terms

  • Celiac Disease* / classification
  • Celiac Disease* / diagnosis
  • Celiac Disease* / diet therapy
  • Celiac Disease* / epidemiology
  • Celiac Disease* / immunology
  • Diet, Gluten-Free
  • Glutens / adverse effects*
  • Humans
  • Predictive Value of Tests
  • Prognosis
  • Risk Factors
  • Wheat Hypersensitivity* / classification
  • Wheat Hypersensitivity* / diagnosis
  • Wheat Hypersensitivity* / diet therapy
  • Wheat Hypersensitivity* / epidemiology
  • Wheat Hypersensitivity* / immunology

Substances

  • Glutens