Systematic Review: Noncoeliac Gluten Sensitivity
A. Molina-Infante, S. Santolaria, M. Montoro, M. Esteve, F. Fernández-Bañares
Published in Alimentary Pharmacology & Therapeutics
Abstract
This systematic review examined double-blind, placebo-controlled gluten challenge studies in patients with self-reported non-coeliac gluten sensitivity (NCGS) to evaluate the specificity of gluten as the causative trigger of symptoms.
Methodology
Reviewed studies applying gluten versus placebo rechallenge in patients with presumed NCGS, most conducted in a low-FODMAP background diet, assessing symptom recurrence.
Key Findings
Only a minority of patients with presumed NCGS showed specific gluten-induced symptoms on rechallenge; many reacted similarly to placebo, suggesting nocebo effects and a possible role of fermentable carbohydrates (FODMAPs) rather than gluten itself.
Conclusions
True NCGS attributable specifically to gluten is present in only a subset of self-diagnosed patients; FODMAPs and nocebo responses substantially confound diagnosis.
Limitations
Small sample sizes across included trials, heterogeneous gluten challenge doses and durations, and lack of validated biomarkers for NCGS diagnosis.
Related Health Concerns
Study Details
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