Non-celiac wheat sensitivity: rationality and irrationality of a gluten-free diet in individuals affected with non-celiac disease: a review.
Study Goal
The researchers aimed to summarize recent advances in understanding non-celiac wheat sensitivity (NCWS), focusing on clinical and etiological controversies, diagnostic criteria, and histological aspects.
Results Summary
The study found that NCWS diagnosis relies on symptom improvement with a gluten-free diet and symptom reappearance after gluten challenge, though the condition's etiology remains unclear. The Salerno criteria may aid accurate diagnosis, but self-labeling via social media complicates the process.
Population
Individuals with non-celiac wheat sensitivity (NCWS) after excluding celiac disease and wheat allergy.
Effective Dosage
Not specified
Duration
Limited period (not specified)
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
removal of wheat-containing foodstuff from the diet | decrease | intestinal and/or extraintestinal symptoms | patients with non-celiac gluten or wheat sensitivity (NCWS) | - | improve | #1 |
gluten-free diet | decrease | symptoms | patients with non-celiac gluten or wheat sensitivity (NCWS) | - | positive response | #2 |
gluten challenge | increase | symptoms | patients with non-celiac gluten or wheat sensitivity (NCWS) | - | reappearance | #3 |
Non-celiac gluten or wheat sensitivity (NCWS) is a "clinical entity induced by the ingestion of wheat leading to intestinal and/or extraintestinal symptoms that improve once the wheat-containing foodstuff is removed from the diet, and celiac disease and wheat allergy have been excluded". This mostly accepted definition raises several points that remain controversial on this condition. In the present review, the authors summarize the most recent advances in the clinic and research on NCWS through an accurate analysis of different studies. We screened PubMed, Medline, Embase, and Scopus using the keywords "non-celiac gluten sensitivity", "non-celiac wheat sensitivity", and "diagnosis". We would like to emphasize two main points, including (A) the controversial clinical and etiological aspects in different trials and experiences with particular attention to the Salerno criteria for the diagnosis of NCWS and (B) the histological aspects. The etiology of NCWS remains controversial, and the relationship with irritable bowel syndrome is obscure. Histologically, the duodenal mucosa may show a variable pattern from unremarkable to a slight increase in the number of T lymphocytes in the superficial epithelium of villi. The endorsement of this disease is based on a positive response to a gluten-free diet for a limited period, followed by the reappearance of symptoms after gluten challenge. The Salerno expert criteria may help to diagnose NCWS accurately. Social media and inaccurate interpretation of websites may jeopardize the diagnostic process if individuals self-label as gluten intolerant.