Letter: gluten challenge in the era of noncoeliac gluten sensitivity – a change in clinical practice?

Wheat challenge in self-reported gluten sensitivity: a comparison of scoring methods

“…Raju et al who confirmed the diagnosis in 82 % of patients with suspected NCGS, after a 6 week open bread challenge in a clinical setting [19]. Apart from a longer challenge, this report has a setting and method comparable to the present study.…”

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

“…They must be treated with great caution and if such patients present to clinicians it is imperative to first exclude celiac disease [ 2 , 3 , 4 ] or other causes not related to any specific trigger (placebo effect, implementation of a healthier diet, etc.). Such patients can be advised that simply by identifying gluten as a culprit for their symptoms, this gives them a risk ranging from 2% to 42% of having undiagnosed celiac disease (based on the current published literature) [ 8 , 15 , 16 , 17 , 18 , 19 ]. This extreme variation reflects an ascertainment bias related to the referral patterns of the centers that have published their data.…”

What’s in a name? ‘Non-coeliac gluten or wheat sensitivity’: controversies and mechanisms related to wheat and gluten causing gastrointestinal symptoms or disease

“…In the absence of coeliac disease and under the guise of the increasingly fashionable but controversial label ‘non-coeliac gluten/wheat sensitivity’ (NCG/WS), gluten has been popularised in the press as a potential cause of almost all possible conceivable physiological complaints, ranging from GI to neurological, dermatological, psychological and musculoskeletal symptoms 9 10. The phenomenon of self-reported gluten or wheat sensitivity has reached such proportions that 15% of Australians believe their chronic GI symptoms are due to gluten or wheat,11 with similar numbers reported in other international studies,11 some of whom may have true undiagnosed coeliac disease 12…”