Cited by 66Celiac Disease Research and ManagementGastrointestinal motility and disordersFood composition and properties

Non-Celiac Gluten Sensitivity in the Context of Functional Gastrointestinal Disorders

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Barbaro, Maria Raffaella, Cremon, Cesare, Wrona, Diana, Fuschi, Daniele, Marasco, Giovanni, Stanghellini, Vincenzo, Barbara, Giovanni·2020·Nutrients

Abstract

Gluten-free diets are increasingly chosen in the Western world, even in the absence of a diagnosis of celiac disease. Around 10% of people worldwide self-report gluten-related complaints, including intestinal and extra-intestinal symptoms. In most cases, these subjects would be labeled as patients suffering from irritable bowel syndrome (IBS) who place themselves on a gluten-free diet even in the absence of celiac disease. In some instances, patients report a clear benefit by avoiding gluten from their diet and/or symptom worsening upon gluten reintroduction. This clinical entity has been termed non-celiac gluten sensitivity (NCGS). The symptoms referred by these patients are both intestinal and extra-intestinal, suggesting that similarly to functional gastrointestinal disorders, NCGS is a disorder of gut–brain interaction. It remains unclear if gluten is the only wheat component involved in NCGS. The mechanisms underlying symptom generation in NCGS remain to be fully clarified, although in the past few years, the research has significantly moved forward with new data linking NCGS to changes in gut motility, permeability and innate immunity. The diagnosis is largely based on the self-reported reaction to gluten by the patient, as there are no available biomarkers, and confirmatory double-blind challenge protocols are unfeasible in daily clinical practice. Some studies suggest that a small proportion of patients with IBS have an intolerance to gluten. However, the benefits of gluten-free or low-gluten diets in non-celiac disease-related conditions are limited, and the long-term consequences of this practice may include nutritional and gut microbiota unbalance. Here, we summarize the role of gluten in the clinical features, pathophysiology, and management of NCGS and disorders of gut–brain interaction.

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  • Intestinal dysbiosis, permeability defects, inflammatory processes, aberrant immune reactions, and other alterations in the microbiota-gut-brain axis are the main factors currently involved in the pathophysiology of ASD.

    “Intestinal dysbiosis, permeability defects, various inflammatory processes, aberrant immune reactions [5,70], and other alterations in the microbiota–gut–brain axis are the main factors currently involved in the pathophysiology of ASD [71].”

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Authors
Barbaro, M. R., Cremon, C., Wrona, D., Fuschi, D., Marasco, G., Stanghellini, V., & Barbara, G.
Affiliations
IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT)
Corresponding author
Barbara, Giovanni
Venue
Nutrients
Publisher
MDPI AG
Published
2020-12-04
Volume
12
Issue
12
Pages
3735
ISSN
2072-6643 (ISSN-L)
OpenAlex
W3106768465
Cited by
66
References
113
Citations by year
2026: 10 · 2025: 9 · 2024: 8 · 2023: 19 · 2022: 13 · 2021: 7
FWCI
1.69
Type
journal article
Language
en
Open access
Locations
  • Nutrients (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
the Italian Ministry of Education, University and Research;University of Bologna; Fondazione del Monte di Bologna e Ravenna;Italian Ministry of Health (Ricerca Finalizzata GR-2018-12367062)
Topics
  • Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Nursing › Nutrition and Dietetics › Food composition and properties
Keywords
non-celiac gluten sensitivity, functional gastrointestinal disorders, irritable bowel syndrome, gluten-free diet, gut-brain axis, intestinal permeability, intestinal motility, innate immunity, biomarkers, gut microbiota, nutrient effects
MeSH terms
Gastrointestinal Microbiome, Celiac Disease, Female, Gastrointestinal Diseases, Gastrointestinal Motility, Glutens, Humans, Immunity, Innate, Male, Wheat Hypersensitivity, Irritable Bowel Syndrome, Diet, Gluten-Free

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