Absence of somatization in non-coeliac gluten sensitivity

Brottveit, Margit; Vandvik, Per Olav; Wojniusz, Slawomir; Løvik, Astrid; Lundin, Knut E.A.; Boye, Birgitte

doi:10.3109/00365521.2012.679685

Cited by 52 publications

(40 citation statements)

References 43 publications

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“…Brottveit et al [108] considered the presence of somatization, personality traits, anxiety, depression, and health-related quality of life in NCGS patients compared to CD patients and healthy controls and compared the response to gluten challenge in the former and the latter. NCGS patients did not exhibit any tendency for general somatization.…”

Section: Clinical Characteristics Of Ncgsmentioning

confidence: 99%

Non-Celiac Gluten Sensitivity: Literature Review

Mansueto

Seidita

D’Alcamo

et al. 2014

Journal of the American College of Nutrition

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Key words: non-celiac gluten sensitivity, celiac disease, wheat allergy, food allergy, HLA, flow cytometric basophil activation test, innate immune response Background: A significant percentage of the general population report problems caused by wheat and/or gluten ingestion, even though they do not have celiac disease (CD) or wheat allergy (WA), because they test negative both for CD-specific serology and histopathology and for immunoglobulin E (IgE)-mediated assays. Most patients report both gastrointestinal and nongastrointestinal symptoms, and all report improvement of symptoms on a gluten-free diet. This clinical condition has been named non-celiac gluten sensitivity (NCGS).Aim: We attempt to define the current pathogenic, clinical, and diagnostic criteria of this "new" disease, to provide a practical view that might be useful to evaluate, diagnose, and manage NCGS patients.Methods: We reviewed the international literature through PubMed and Medline, using the search terms "wheat (hyper)sensitivity," "wheat allergy," "wheat intolerance," "gluten (hyper)sensitivity," and "gluten intolerance," and we discuss current knowledge about NCGS.Results: It has been demonstrated that patients suffering from NCGS are a heterogeneous group, composed of several subgroups, each characterized by different pathogenesis, clinical history, and, probably, clinical course. NCGS diagnosis can be reached only by excluding CD and WA. Recent evidence shows that a personal history of food allergy in infancy, coexistent atopy, positive for immunoglobulin G (IgG) antigliadin antibodies and flow cytometric basophil activation test, with wheat and duodenal and/or ileum-colon intraepithelial and lamina propria eosinophil counts, could be useful to identify NCGS patients.Conclusions: Future research should aim to identify reliable biomarkers for NCGS diagnosis and to better define the different NCGS subgroups. Key teaching points:• Most patients report both gastrointestinal and nongastrointestinal symptoms, and all agree that there is an improvement of symptoms on a gluten-free diet.• NCGS diagnosis can be reached only by excluding celiac disease and wheat allergy.• Patients suffering from NCGS are a heterogeneous group, composed of several subgroups, each characterized by different pathogenesis, clinical history, and, probably, clinical course.• A personal history of food allergy in infancy, coexistent atopy, positive IgG antigliadin antibodies (AGA) and flow cytometric basophil activation test, with wheat and duodenal and/or ileum-colon intraepithelial and lamina propria eosinophil counts, could be useful to identify NCGS patients.• Future research should aim to identify reliable biomarkers for NCGS diagnosis and to better define the different NCGS subgroup. Abbreviations: CD = celiac disease, WA = wheat allergy, NCGS = non-celiac gluten sensitivity, GFD = gluten-free diet, IBS = irritable bowel syndrome, HLA = human leukocyte antigen, tTg = antitissue transglutaminase, AGA = antigliadin antibodies, EMA = endomysial antigen, DGP = deami...

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Section: Clinical Characteristics Of Ncgsmentioning

confidence: 99%

Non-Celiac Gluten Sensitivity: Literature Review

Mansueto

Seidita

D’Alcamo

et al. 2014

Journal of the American College of Nutrition

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“…Interesującą podgrupę stanowią dzieci z autyzmem oraz objawami z przewodu pokarmowego, u których często stwierdza się obecność IgGAGA, rzadziej IgAAGA, a nie występują IgGdAGA [2,8]. W wieku dorosłym u chorych na NCNG nie stwierdzono powiązania między nasileniem relacjonowanych dolegliwości podczas prowokacji glutenem a typem osobowości, niestety dotychczas nie przeprowadzono podobnych badań z udziałem dzieci [21].…”

Section: Ncng -Choroba Czy Zespół Chorób?unclassified

Non-celiac gluten sensitivity (NCGS) – an old diagnosis recently rediscovered

Hozyasz¹

2016

fmpcr

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A -przygotowanie projektu badania, B -zbieranie danych, C -analiza statystyczna, D -interpretacja danych, E -przygotowanie maszynopisu, F -opracowanie piśmiennictwa, G -pozyskanie funduszy W medycynie akademickiej nieceliakalna nadwrażliwość na gluten (NCNG, ang. non-celiac gluten sensitivity) jest nowo zaakceptowanym rozpoznaniem klinicznym, którego istnienie było długo negowane. Częstość występowania NCNG w populacji ogólnej, jak i w grupach zwiększonego ryzyka, nie została dotychczas precyzyjnie określona, gdyż pacjenci często sami wysuwają podejrzenie tej choroby i wprowadzają restrykcyjną, jak w celiakii, dietę bezglutenową bez nadzoru medycznego. Definicja NCNG obejmuje zróżnicowaną grupę pacjentów. Nie zidentyfikowano swoistego biomarkera choroby. Rozpoznanie NCNG ustala się po wykluczeniu celiakii i alergii na pszenicę. Objawy choroby ustępują na diecie bezglutenowej, a nawracają po ponownym wprowadzeniu glutenu. Istnienie nowej jednostki nozologicznej potwierdził konsensus ekspercki, jakkolwiek szczegółowa patofizjologia choroby, leżąca u podstaw bardzo zróżnicowanej manifestacji klinicznej, obejmującej m.in. ból brzucha, biegunkę lub zaparcia, uporczywe wzdęcia, niedokrwistość, drętwienia kończyn, ból stawów i mięśni, zaburzenia snu, przewlekłe zmęczenie i depresję, pozostaje nieznana. Brakuje wiedzy dotyczącej naturalnego przebiegu schorzenia. Pomimo braku precyzyjnych kryteriów diagnostycznych choroba stanowi dowód per se na możliwość skutecznego leczenia dietą zaburzeń przewodu pokarmowego i dysfunkcji psychicznych. Z powodu przekonania o prozdrowotnych właści-wościach pokarmów bezglutenowych dietę bezglutenową stosuje coraz więcej ludzi zdrowych, także w Polsce. Profesjonaliści medyczni muszą być świadomi, że certyfikowane produkty bezglutenowe są drogie i nieuzasadnione medycznie stosowanie diety bezglutenowej w wielu przypadkach może niepotrzebnie pogarszać kondycję finansową rodzin. Słowa kluczowe: nadwrażliwość na gluten, celiakia, alergia na gluten.Non-celiac gluten sensitivity (NCGS) is a newly recognised clinical entity by academic medical professionals, but it is better to consider it an old diagnosis recently rediscovered. The overall prevalence of NCGS in the general population is currently unknown largely because patients often self-diagnose and place themselves on the celiac-type gluten-free diet (GFD) without medical supervision. NCGS is an umbrella term and may incorporate different subgroups of patients. Now there is no specific biomarker that can be used to identify the entity. NCGS diagnosis can be reached only by excluding celiac disease and wheat allergy. Symptoms must disappear with the withdrawal of gluten and reappear quickly when gluten is reintroduced. NCGS existence has been recently supported by two expert meetings, however mechanisms by which gluten triggers symptoms, mimicking irritable bowel syndrome and skin rashes, numbness,"foggy mind", disturbed sleep patterns, have yet to be identified. Knowledge about NCGS natural history and outcome is still lacking. NCNG is the ...

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“…While it was hypothesised that gluten may induce depression as a consequence of changes in brain serotonin, gluten exorphins or changes in gut microbiota, we believe that it was unlikely to be via the induction of low-grade gut inflammation or changes in intestinal permeability. No changes to any biomarkers of these events were identified in this or previous well controlled studies, 6,7 although duodenal biopsies were not performed after challenges with gluten or placebo. We wholeheartedly agree with Aziz et al regarding the limitations of this study.…”

mentioning

confidence: 94%

“…4 It has been noted that treatment of the underlying disease process can lead to alleviation of anxiety and neuroticism. 5 This may also be the case in NCGS subjects who exhibit low levels of somatisation while on a GFD, 6 with Peters et al subsequently demonstrating blinded gluten exposure to induce a state of depression. 1 These findings are similar to that seen in coeliac disease where depression is commonly reported, 7 and a GFD in symptomatic individuals leads to an improvement in perception of health and psychological well-being.…”

mentioning

confidence: 99%