Celiac Disease and Nonceliac Gluten Sensitivity

Watkins, Runa; Zawahir, Shamila

doi:10.1016/j.pcl.2017.01.013

Cited by 17 publications

(22 citation statements)

References 86 publications

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“…Special interest by the public in this causal relationship began in the 1980s and is continuously increasing, yet remains controversial. It has also generated much attention in the medical profession . The phenomenon is being promoted partly by persuasive information in various media, particularly the Internet and social media, and by the GFD manufacturers’ strong advertisements portraying better health, energy, and beauty.…”

Section: Nonceliac Gluten Sensitivitymentioning

confidence: 99%

Gluten sensitivities and the allergist: Threshing the grain from the husks

Burkhardt

Chapa-Rodríguez

Bahna

2017

Allergy

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Abstract"Gluten sensitivity" has become commonplace among the public. Wheat allergy (WA) and celiac disease (CD) are well-defined entities, but are becoming a fraction of individuals following a gluten-free diet (GFD). Wheat allergy has a prevalence of <0.5%. Wheat, specifically its omega-5 gliadin fraction, is the most common allergen implicated in food-dependent, exercise-induced anaphylaxis. CD is a non-IgE hypersensitivity to certain cereal proteins: gluten in wheat, secalin in rye, hordein in barley, and to a lesser extent avenin in oat. It is a rare disease, with an estimated prevalence that varied widely geographically, being higher in Northern Europe and the African Saharawi region than in South-East Asia. In addition to suggestive symptoms, serologic testing has high diagnostic reliability and biopsy is a confirmatory procedure. Patients with CD have extra-intestinal autoimmune comorbid conditions more frequently than expected. A third entity is nonceliac gluten sensitivity, which has been created because of the increasing number of subjects who claim a better quality of life or improvement of their variety of symptoms on switching to a GFD.The phenomenon is being fueled by the media and exploited by the industry. The lack of a specific objective test has been raising substantial controversy about this entity. Allergists and gastroenterologists need to pay attention to the multitudes of individuals who elect to follow a GFD. Many such subjects might have WA, CD, or another illness. Providing them with appropriate evaluation and specific management would be of great advantages, medically and economically. K E Y W O R D Sceliac disease, gluten sensitivity, gluten-free diet, nonceliac gluten sensitivity, wheat allergy 1 | INTRODUCTION "Gluten" has become part of everyday vocabulary by the public, a popular topic by the media, and is being exploited by the food industry. Three wheat-related disorders have been described, namely wheat allergy (WA), celiac disease (CD), and the new entity nonceliac gluten sensitivity (NCGS). The objective of this paper was to differentiate between these 3 disorders regarding epidemiology, manifestations, pathogenesis, diagnosis, and management. As a timely topic, "gluten sensitivity" stimulated the publication of multiple reviews, mainly in the gastroenterology and nutrition literatures, but not so in the allergy literature. Fueled by the media and the food industry's promotion of gluten-free products, the number of subjects claiming gluten-related illnesses has been exponentially increasing and they are seeking or referred for allergy evaluation.

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Section: Nonceliac Gluten Sensitivitymentioning

confidence: 99%

Gluten sensitivities and the allergist: Threshing the grain from the husks

Burkhardt

Chapa-Rodríguez

Bahna

2017

Allergy

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“…[1,4,5] About 1 in 100 people are diagnosed with celiac disease. [6,7] The prevalence of celiac disease is increasing in the U.S. due to increased awareness and better diagnostic techniques, however researchers estimate that for each diagnosed case of celiac disease there may be 3-7 undiagnosed cases. [1,3,5,7,8,9] The current treatment for celiac disease is to eliminate gluten from the diet.…”

Section: Introductionmentioning

confidence: 99%

“…[1,10] Estimates of strict adherence to a gluten free diet range from 42% to 91%, depending on the study population and how compliance was defined and measured in the study. [3,5,7,11,12] Intentionally eating gluten is most likely during social situations including eating outside the home. [1,8,13,14,15] One in five adolescents and adults with celiac disease said they eat food containing gluten at least once a month.…”

Section: Introductionmentioning

confidence: 99%

“…[13,16,18] Children and adults also experienced anxiety over their constant monitoring of what they eat, and most (68%) said this reduced their enjoyment of food. [7,16,20] College attendance represents a transition to more independent decision making for young adults where they establish behavior patterns that they carry with them into adulthood. [22] How college students manage their celiac disease as they establish independence from their parents is critical for lifelong compliance with a gluten free diet.…”

Section: Introductionmentioning

confidence: 99%

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Individual and Social Influences on College Student Compliance with a Gluten-Free Diet

Sparks¹,

Zingg²,

Cheney³

2019

IJCD

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The objective of this study was to examine individual and social influences on college student compliance with a gluten-free diet. Individual semi-structured interviews were conducted in 2016-2017 with undergraduates (n=24) at a large public university. Eligible participants were 18-25 years old with self-reported physician-diagnosed celiac disease. The interview question path was based on the Health Belief Model and assessed individual and social influences on eating choices. Transcribed interviews were independently coded by three researchers (ICR=.82) then analyzed for themes using the Health Belief Model as a guiding framework. Barriers to complying with a gluten-free diet included the college meal plan, meal planning and cooking skills, negotiating social interactions around food, financial burden of purchasing gluten-free food, and intentionally eating gluten as self-confidence grew. Students often reframed non-compliance as a "cheat day," discussing it as they would a reduced-calorie diet, which could reduce perceived threat. Providers discussed threats to health in terms of long-term outcomes but students focused on the immediate impact of eating gluten. Nutritionists, parents, and health care providers can better prepare college students for the transition to independent food choices and how to remain compliant with a gluten-free diet within the challenging college food environment.

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“…2,3 A alergia ao trigo (AT) está igualmente bem estabelecida, tratando-se de uma reação de hipersensibilidade, mediada ou não mediada pela imunoglobulina E (IgE). 4 Recentemente, vem emergindo outra condição relacionada ao glúten, que envolve grande apelo popular, geralmente denominada sensibilidade não-celíaca ao glúten, [5][6][7] denominação criticada por Jericho et al, que a consideram imprópria, dado que o envolvimento do glúten carece de evidência, ao contrário do trigo. Além disso, o papel imunológico sugerido pelo termo "sensibilidade" ainda é, segundo eles, infundado.…”

Section: Introductionunclassified

Untitled

2018

International Journal of Nutrology

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Palavras-chave► sensibilidade não celíaca ao glúten ► sensibilidade ao glúten ► sensibilidade ao trigo ► doenças relacionadas ao glúten ► dieta isenta de glúten ► glúten ► trigo ResumoEntre as reações adversas a alimentos, os distúrbios relacionados ao glúten vêm atualmente ganhando cada vez mais espaço nas publicações científicas e não científicas. Estes distúrbios são divididos em três entidades: doença celíaca (DC), alergia ao trigo (AT) e sensibilidade não-celíaca ao glúten ou ao trigo (SNCG/T), considerando que este cereal vem sendo associado mais frequentemente às manifestações, discutindo-se ainda se não seria o real componente alimentar desencadeante. A DC é uma enteropatia autoimune, enquanto a AT é uma reação de hipersensibilidade, mediada ou não mediada pela imunoglobulina E (IgE). A SNCG/T é uma entidade emergente, de fisiopatologia ainda discutida, que vários pesquisadores propõem como diagnóstico de exclusão em relação à AT e à DC. A SNCG/T vem despertando grande celeuma popular e polêmica nos meios médicos. A presente revisão tem por objetivo abordar a SNCG/T, procurando elencar elementos de distinção dos outros dois distúrbios retrocitados discutindo aspectos como características clínicas, diagnóstico diferencial, fisiopatologia e tratamento. Em muitos trabalhos, salienta-se a possibilidade de sobreposição ou de confusão diagnóstica com outras doenças funcionais gastrointestinais, como síndrome do intestino irritável (SII) e oligossacarídeos, dissacarídeos, monossacarídeos e polióis fermentáveis (FODMAPs, na sigla em inglês). Concluímos que a SNGG/T, embora constitua uma entidade clínica reconhecida por um número expressivo de pesquisadores, ainda é objeto de amplo questionamento quanto à sua caracterização, ao seu diagnóstico e à sua fisiopatologia. Isto posto, considerando sua elevada prevalência estimada e as repercussões populares, indubitavelmente trata-se de assunto digno de estudos mais aprofundados e bem conduzidos. Keywords► non-celiac gluten sensitivity ► sensitivity to gluten ► sensitivity to wheat ► gluten-related diseases ► gluten-free diet ► gluten ► wheat Abstract Among adverse food reactions, gluten-related disorders are now gaining more and more space in scientific and non-scientific publications. These disorders are divided into three entities: celiac disease (CD), wheat allergy (WA), and non-celiac sensitivity to gluten or wheat (NCGS), considering that this cereal is associated more frequently with the manifestations, and since it is also discussed whether or not this grain would be the real triggering food component. Celiac disease is an autoimmune enteropathy, whereas WA is a hypersensitive reaction, mediated or not mediated by immunoglobulin E (IgE). Non-celiac sensitivity to gluten or wheat is an emerging entity of pathophysiology still under discussion, which several researchers propose as a diagnosis of exclusion in relation to CD and WA, and it has aroused great popular excitement and controversy in medical circles. The present review aims to approach NCGS, seeking to di...

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Celiac Disease and Nonceliac Gluten Sensitivity

Cited by 17 publications

References 86 publications

Gluten sensitivities and the allergist: Threshing the grain from the husks

Gluten sensitivities and the allergist: Threshing the grain from the husks

Individual and Social Influences on College Student Compliance with a Gluten-Free Diet

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