Is it time to rethink the burden of non-coeliac gluten sensitivity? A systematic review.
Study Goal
The researchers aimed to describe the clinical features of non-coeliac gluten sensitivity (NCGS) and estimate its prevalence, as well as assess the symptomatic response to a gluten-free diet (GFD).
Results Summary
The study found that NCGS patients were predominantly middle-aged females with symptoms like abdominal pain, bloating, and diarrhea. The prevalence of NCGS after double-blind, placebo-controlled trials was 24%, and symptomatic response to GFD varied widely (7%-93%). Long-term benefits of GFD remain unclear.
Population
Middle-aged females with non-coeliac gluten sensitivity, including those with irritable bowel syndrome or self-reported gluten intolerance.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
gluten intake | neutral | clinical features | gluten-sensitive patients | - | symptomatic response | #1 |
- | neutral | clinical features | gluten-sensitive patients | - | predominately | #2 |
- | neutral | NCGS | patients after DBPCC | 24% (5-34%) | pooled prevalence | #3 |
gluten-free diet (GFD) | neutral | symptoms | patients | between 7% and 93% | symptomatic response | #4 |
gluten-free diet (GFD) | no change | outcomes | NCGS patients | - | long-term benefit | #5 |
INTRODUCTION: Non-coeliac gluten sensitivity (NCGS) is still a poorly defined clinical condition. This review aims to describe the clinical features of subjects with a symptomatic response to gluten intake, and to estimate the prevalence of NCGS. EVIDENCE ACQUISITION: Literature search was conducted in accordance with PRISMA recommendations. The PubMed database was searched for original articles until 1 EVIDENCE SYNTHESIS: We identified 30 relevant articles, including 14 studies that investigated NCGS through a double-blind, placebo-controlled crossover trial (DBPCC), and 16 that examined the role of gluten in causing symptoms without a DBPCC. We found that regardless of the diagnostic work up, gluten-sensitive patients were predominately middle-aged females complaining of abdominal pain, bloating and diarrhea. The pooled prevalence of NCGS after DBPCC was 24% (5-34%). Subjects with irritable bowel syndrome or self-reporting gluten intolerance accounted for the vast majority of the patients who did not start a DBPCC. A symptomatic response to a gluten-free diet (GFD) occurred in between 7% and 93% of patients. No data on long-term outcomes of NCGS individuals were reported. CONCLUSIONS: Clinical features of NCGS patients did not differ among all the included studies, whereas prevalence figures are rather heterogeneous. Long-term benefit of a GFD on these patients still needs to be ascertained.