Non-Celiac Gluten Sensitivity among Patients Perceiving Gluten-Related Symptoms

Digestion. 2015;92(1):8-13. doi: 10.1159/000430090. Epub 2015 May 30.

Abstract

Background: Non-celiac gluten sensitivity (NCGS) is a recently recognized disorder, characterized by the occurrence of symptoms following gluten ingestion. It is often self-diagnosed by the patient, but should be confirmed by the response to a gluten-free diet, followed by a gluten challenge. Celiac disease (CD) and wheat allergy (WA) must first be ruled out.

Aims: (1) to determine the frequency of visits performed for symptoms self-perceived as gluten-related; (2) to assess in this cohort, the proportion of patients satisfying the diagnostic criteria for NCGS.

Methods: A two-year prospective study including all consecutive patients complaining of gluten-related symptoms. NCGS was diagnosed on the basis of the disappearance of the symptoms within 6 months of a gluten-free diet, followed by their reappearance with the reintroduction of gluten in the diet for 1 month.

Results: Three hundred and ninety two patients complaining of gluten-related symptoms were enrolled; 26 of these (6.63%) were affected by CD, 2 (0.51%) by WA and 27 were diagnosed with NCGS (6.88%). The remaining 337 patients (85.96%) did not experience any change of symptoms with a gluten-free diet. The PPV of the gluten-related symptom was found to be 7%.

Conclusion: Eighty six percent of patients reporting gluten-related symptoms have neither NCGS, nor CD, nor WA. Self-perceived gluten-related symptoms are rarely indicative of the presence of NCGS.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Celiac Disease / diagnosis
  • Celiac Disease / epidemiology
  • Diagnosis, Differential
  • Diagnostic Self Evaluation*
  • Diet, Gluten-Free*
  • Female
  • Glutens / adverse effects*
  • Humans
  • Intestinal Diseases / diagnosis
  • Intestinal Diseases / epidemiology*
  • Intestinal Diseases / etiology
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Wheat Hypersensitivity / diagnosis
  • Wheat Hypersensitivity / epidemiology

Substances

  • Glutens