The Overlapping Area of Non-Celiac Gluten Sensitivity (NCGS) and Wheat-Sensitive Irritable Bowel Syndrome (IBS): An Update

Catassi, Carlo; Alaedini, Armin; Bojarski, Christian; Bonaz, Bruno; Bouma, Gerd; Carroccio, Antonio; Castillejo, Gemma; Magistris, Laura de; Dieterich, Walburga; Liberto, Diana Di; Elli, Luca; Fasano, Alessio; Hadjivassiliou, Marios; Kurien, Matthew; Lionetti, Elena; Mulder, Chris J.; Rostami, Kamran; Sapone, Anna; Scherf, Katharina Anne; Schuppan, Detlef; Trott, Nick; Volta, Umberto; Zopf, Yurdagül; Sanders, David S.

doi:10.3390/nu9111268

Cited by 188 publications

(198 citation statements)

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“…described chronic diarrhea that improved after a gluten‐free diet (GFD) and was triggered by gluten challenge in subjects without celiac disease. Since then, studies have reported conflicting results leading to a shift in terminology, non‐celiac wheat sensitivity (NCWS), which reflects our uncertainty on the exact trigger and mechanisms involved …”

Section: Introductionmentioning

confidence: 99%

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Non‐celiac gluten or wheat sensitivity: It's complicated!

Sánchez

Verdú

2018

Neurogastroenterology Motil

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In the last 30 years, non‐celiac gluten sensitivity (NCGS) has emerged as an intriguing and controversial topic in gastroenterology. The diagnosis of NCGS/NCWS requires a symptomatic reaction to gluten, or wheat‐containing food, and remission of symptoms with gluten or wheat challenge, in patients in whom celiac disease and wheat allergy have been excluded. There have been several randomized clinical trials (RCT) addressing this issue which have produced controversial results. In this issue of Neurogastroenterology and Motility, a double‐blind placebo‐controlled randomized trial in patients with suspected NCGS on GFD, did not reproduce symptoms after gluten intake compared to placebo. This mini‐review addresses outstanding issues related to the diagnosis of NCGS/NCWS as well as areas of interest for future studies that could explain, in part, the controversy in this area.

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Section: Introductionmentioning

confidence: 99%

“…Challenge should be performed for 1 week, followed by a 1‐week washout . In a recent review, a new definition was introduced to include patients who present with irritable bowel syndrome (IBS)‐type symptoms and may have “gluten or wheat‐sensitive IBS” …”

Section: Introductionmentioning

confidence: 99%

Non‐celiac gluten or wheat sensitivity: It's complicated!

Sánchez

Verdú

2018

Neurogastroenterology Motil

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“…For a detailed overview of characteristics and symptoms associated with CD, WA, and NCWS, see Catassi et al. () and Catassi, Elli, et al. ().…”

Section: Non‐celiac Gluten/wheat Sensitivitymentioning

confidence: 99%

Adverse Reactions to Wheat or Wheat Components

Brouns

Rooy

Shewry

et al. 2019

Comp Rev Food Sci Food Safe

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Wheat is an important staple food globally, providing a significant contribution to daily energy, fiber, and micronutrient intake. Observational evidence for health impacts of consuming more whole grains, among which wheat is a major contributor, points to significant risk reduction for diabetes, cardiovascular disease, and colon cancer. However, specific wheat components may also elicit adverse physical reactions in susceptible individuals such as celiac disease (CD) and wheat allergy (WA). Recently, broad coverage in the popular and social media has suggested that wheat consumption leads to a wide range of adverse health effects. This has motivated many consumers to avoid or reduce their consumption of foods that contain wheat/gluten, despite the absence of diagnosed CD or WA, raising questions about underlying mechanisms and possible nocebo effects. However, recent studies did show that some individuals may suffer from adverse reactions in absence of CD and WA. This condition is called non‐celiac gluten sensitivity (NCGS) or non‐celiac wheat sensitivity (NCWS). In addition to gluten, wheat and derived products contain many other components which may trigger symptoms, including inhibitors of α‐amylase and trypsin (ATIs), lectins, and rapidly fermentable carbohydrates (FODMAPs). Furthermore, the way in which foods are being processed, such as the use of yeast or sourdough fermentation, fermentation time and baking conditions, may also affect the presence and bioactivity of these components. The present review systematically describes the characteristics of wheat‐related intolerances, including their etiology, prevalence, the components responsible, diagnosis, and strategies to reduce adverse reactions.

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“…It is thought that wheat‐related components, such as fructans, wheat germ agglutinins, or amylase alpha‐trypsin inhibitors, may underlie NCWS‐related IBS symptoms by inducing low‐grade inflammation, altering barrier function, and the consequences of fermentation . In one study, IBS patients on an LFD were reintroduced to varying amounts of gluten (0, 2, or 16 g/day).…”

Section: Dietmentioning

confidence: 99%

Targeting the gut microbiota for the treatment of irritable bowel syndrome

Herndon

Wang

2019

The Kaohsiung J of Med Scie

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Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder that affects an estimated 11% of people across the world. IBS patients are one of the largest subgroups seen in gastroenterology clinics, exhibit a lesser quality of life, and take greater use of the healthcare system. The exact etiology of IBS remains uncertain. Alterations in the gut microbiome may characterize apotential mechanism in the pathogenesis of IBS. This hypothesis is paralleled by rodent models in which manipulation of the gut microbiota leads to disturbed physiological functions along the brain‐gut axis. Recent research in IBS treatments has redirected its focus towards gu microbiome based therapeutics. In this review, we discuss potential roles of enteric bacteria in the pathogenesis of IBS and its comorbidities. We then explore the manipulation of the enteric microbiota by prebiotics, probiotics, antibiotics, dietary changes, and fecal microbiota transfer. We also discuss the positive and negative effects of these therapeutics on IBS symptoms.

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The Overlapping Area of Non-Celiac Gluten Sensitivity (NCGS) and Wheat-Sensitive Irritable Bowel Syndrome (IBS): An Update

Cited by 188 publications

References 100 publications

Non‐celiac gluten or wheat sensitivity: It's complicated!

Non‐celiac gluten or wheat sensitivity: It's complicated!

Adverse Reactions to Wheat or Wheat Components

Targeting the gut microbiota for the treatment of irritable bowel syndrome

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