Noncoeliac gluten sensitivity

A diagnostic dilemma

Federica Branchi, Imran Aziz, Dario Conte, David S. Sanders

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose of review Noncoeliac gluten sensitivity (NCGS) has gained attention as an emerging clinical entity. Data regarding the epidemiology, pathogenesis, and management of NCGS are scattered in view of the diagnostic uncertainty surrounding the disorder. We aim to provide a current perspective of NCGS and its associated controversies. Recent findings NCGS consists of a spectrum of intestinal and extraintestinal symptoms related to the ingestion of glutencontaining food, yet in the absence of coeliac disease or wheat allergy. To date, no specific biomarker exists for NCGS, thereby leaving the diagnosis to be confirmed by dietary elimination followed by doubleblind placebo-controlled gluten-based rechallenges. Unfortunately, this technique is cumbersome, not readily-available in routine clinical practise, and can still leave the diagnosis of NCGS open to debate as to whether the effects demonstrated can be specifically attributed to the gluten-protein per se or rather coexisting nongluten components, such as fermentable carbohydrates and amylase-trypsin inhibitors. Summary Physicians are increasingly being posed with the dilemma of patients presenting with self-reported NCGS. However, this appears to be the tip of the iceberg and future studies are in need of delineating which gluten-based component is responsible for each individual patient's complaint.

Original languageEnglish
Pages (from-to)508-514
Number of pages7
JournalCurrent Opinion in Clinical Nutrition and Metabolic Care
Volume18
Issue number5
DOIs
Publication statusPublished - Jul 1 2015

Fingerprint

Glutens
Wheat Hypersensitivity
Trypsin Inhibitors
Celiac Disease
Amylases
Uncertainty
Epidemiology
Eating
Biomarkers
Placebos
Carbohydrates
Physicians
Food

Keywords

  • Amylase-trypsin inhibitors
  • Coeliac disease
  • Fermentable carbohydrates
  • Noncoeliac gluten sensitivity
  • Wheat allergy

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Noncoeliac gluten sensitivity : A diagnostic dilemma. / Branchi, Federica; Aziz, Imran; Conte, Dario; Sanders, David S.

In: Current Opinion in Clinical Nutrition and Metabolic Care, Vol. 18, No. 5, 01.07.2015, p. 508-514.

Research output: Contribution to journalArticle

Branchi, Federica ; Aziz, Imran ; Conte, Dario ; Sanders, David S. / Noncoeliac gluten sensitivity : A diagnostic dilemma. In: Current Opinion in Clinical Nutrition and Metabolic Care. 2015 ; Vol. 18, No. 5. pp. 508-514.
@article{a3378afac8f14147afd53d863ef9e1d9,
title = "Noncoeliac gluten sensitivity: A diagnostic dilemma",
abstract = "Purpose of review Noncoeliac gluten sensitivity (NCGS) has gained attention as an emerging clinical entity. Data regarding the epidemiology, pathogenesis, and management of NCGS are scattered in view of the diagnostic uncertainty surrounding the disorder. We aim to provide a current perspective of NCGS and its associated controversies. Recent findings NCGS consists of a spectrum of intestinal and extraintestinal symptoms related to the ingestion of glutencontaining food, yet in the absence of coeliac disease or wheat allergy. To date, no specific biomarker exists for NCGS, thereby leaving the diagnosis to be confirmed by dietary elimination followed by doubleblind placebo-controlled gluten-based rechallenges. Unfortunately, this technique is cumbersome, not readily-available in routine clinical practise, and can still leave the diagnosis of NCGS open to debate as to whether the effects demonstrated can be specifically attributed to the gluten-protein per se or rather coexisting nongluten components, such as fermentable carbohydrates and amylase-trypsin inhibitors. Summary Physicians are increasingly being posed with the dilemma of patients presenting with self-reported NCGS. However, this appears to be the tip of the iceberg and future studies are in need of delineating which gluten-based component is responsible for each individual patient's complaint.",
keywords = "Amylase-trypsin inhibitors, Coeliac disease, Fermentable carbohydrates, Noncoeliac gluten sensitivity, Wheat allergy",
author = "Federica Branchi and Imran Aziz and Dario Conte and Sanders, {David S.}",
year = "2015",
month = "7",
day = "1",
doi = "10.1097/MCO.0000000000000207",
language = "English",
volume = "18",
pages = "508--514",
journal = "Current Opinion in Clinical Nutrition and Metabolic Care",
issn = "1363-1950",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Noncoeliac gluten sensitivity

T2 - A diagnostic dilemma

AU - Branchi, Federica

AU - Aziz, Imran

AU - Conte, Dario

AU - Sanders, David S.

PY - 2015/7/1

Y1 - 2015/7/1

N2 - Purpose of review Noncoeliac gluten sensitivity (NCGS) has gained attention as an emerging clinical entity. Data regarding the epidemiology, pathogenesis, and management of NCGS are scattered in view of the diagnostic uncertainty surrounding the disorder. We aim to provide a current perspective of NCGS and its associated controversies. Recent findings NCGS consists of a spectrum of intestinal and extraintestinal symptoms related to the ingestion of glutencontaining food, yet in the absence of coeliac disease or wheat allergy. To date, no specific biomarker exists for NCGS, thereby leaving the diagnosis to be confirmed by dietary elimination followed by doubleblind placebo-controlled gluten-based rechallenges. Unfortunately, this technique is cumbersome, not readily-available in routine clinical practise, and can still leave the diagnosis of NCGS open to debate as to whether the effects demonstrated can be specifically attributed to the gluten-protein per se or rather coexisting nongluten components, such as fermentable carbohydrates and amylase-trypsin inhibitors. Summary Physicians are increasingly being posed with the dilemma of patients presenting with self-reported NCGS. However, this appears to be the tip of the iceberg and future studies are in need of delineating which gluten-based component is responsible for each individual patient's complaint.

AB - Purpose of review Noncoeliac gluten sensitivity (NCGS) has gained attention as an emerging clinical entity. Data regarding the epidemiology, pathogenesis, and management of NCGS are scattered in view of the diagnostic uncertainty surrounding the disorder. We aim to provide a current perspective of NCGS and its associated controversies. Recent findings NCGS consists of a spectrum of intestinal and extraintestinal symptoms related to the ingestion of glutencontaining food, yet in the absence of coeliac disease or wheat allergy. To date, no specific biomarker exists for NCGS, thereby leaving the diagnosis to be confirmed by dietary elimination followed by doubleblind placebo-controlled gluten-based rechallenges. Unfortunately, this technique is cumbersome, not readily-available in routine clinical practise, and can still leave the diagnosis of NCGS open to debate as to whether the effects demonstrated can be specifically attributed to the gluten-protein per se or rather coexisting nongluten components, such as fermentable carbohydrates and amylase-trypsin inhibitors. Summary Physicians are increasingly being posed with the dilemma of patients presenting with self-reported NCGS. However, this appears to be the tip of the iceberg and future studies are in need of delineating which gluten-based component is responsible for each individual patient's complaint.

KW - Amylase-trypsin inhibitors

KW - Coeliac disease

KW - Fermentable carbohydrates

KW - Noncoeliac gluten sensitivity

KW - Wheat allergy

UR - http://www.scopus.com/inward/record.url?scp=84942774752&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84942774752&partnerID=8YFLogxK

U2 - 10.1097/MCO.0000000000000207

DO - 10.1097/MCO.0000000000000207

M3 - Article

VL - 18

SP - 508

EP - 514

JO - Current Opinion in Clinical Nutrition and Metabolic Care

JF - Current Opinion in Clinical Nutrition and Metabolic Care

SN - 1363-1950

IS - 5

ER -