Non-Celiac Gluten Sensitivity

Non-celiac gluten sensitivity (NCGS) is a poorly defined syndrome characterized by a variable combination of intestinal and extraintestinal symptoms, typically occurring soon after ingestion of gluten-containing foods and disappearing quickly upon their withdrawal, occurring in individuals in whom both celiac disease (CeD) and wheat allergy have been excluded. In Western countries, the prevalence of NCGS is estimated to be around 2–3%. The disorder is more common in females and is a clinical diagnosis. Irritable bowel syndrome (IBS)-type symptoms are usually part of the presenting picture, and it is estimated that NCGS is responsible for one third of cases of IBS in adults. At variance with CeD, the latency between the ingestion of gluten-containing food and the appearance of symptoms is typically short, within hours or few days. The double-blind placebo-controlled (DBPC) gluten challenge with crossover is the gold standard for diagnosing NCGS. Currently an individualized GFD remains the only treatment for NCGS.