Influence of low FODMAP and gluten-free diets on disease activity and intestinal microbiota in patients with non-celiac gluten sensitivity

Dieterich, Walburga; Schuppan, Detlef; Schink, Monic; Schwappacher, Raphaela; Wirtz, Stefan; Agaimy, Abbas; Neurath, Markus F.; Zopf, Yurdagül

doi:10.1016/j.clnu.2018.03.017

Cited by 98 publications

(102 citation statements)

References 38 publications

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“…A more recent article demonstrated that two weeks of a low-FODMAP diet in patients with self-reported NCGS significantly improved symptoms. In addition, this study showed that two weeks of a gluten-free diet (GFD) induced a symptom reduction compared with that reported during the low-FODMAP diet 19 . Attention has been directed to fructans, a component of FODMAPs.…”

Section: Pathophysiologymentioning

confidence: 89%

Recent advances in understanding non-celiac gluten sensitivity

et al. 2018

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Non-celiac gluten sensitivity (NCGS) is a condition characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing foods in the absence of celiac disease and wheat allergy. The diagnosis is cumbersome and currently confirmed only by gluten withdrawal and double-blind placebo challenge protocols. There is great overlap in symptoms between NCGS and other functional gastrointestinal disorders, making a differential diagnosis difficult. The pathophysiology of NCGS is largely unclear, and there are contrasting data on the trigger of this condition. This review will highlight the state-of-the-art knowledge on NCGS and the key open questions.

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Section: Pathophysiologymentioning

confidence: 89%

Recent advances in understanding non-celiac gluten sensitivity

et al. 2018

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“…Diagnostic investigation will be facilitated by both the awareness of these disorders and the careful analysis of the records and food anamnesis. It is important to emphasize that self-report of gluten sensitivity by the patient does not confirm the diagnosis of NCGS and that the prescription of a gluten-free diet for gastrointestinal and other symptoms may lead to underdiagnoses of CD (80)(81)(82)(83)(84) . Recently, Picarelli et al developed an oral mucosal contact test for gluten (GOMPT), which seems to be a reliable and rapid tool to confirm the diagnosis of NCGS, although additional investigations are necessary since the population evaluated was small and the tests performed in a single diagnostic center (44) .…”

Section: Iv-clinical and Therapeutic Aspects Of Ibs And Ncgs Overlapmentioning

confidence: 99%

“…However, prospective studies show that restriction to lactose alone is a trigger for IBS symptoms is not sufficient for the effective relief of symptoms in functional GI disease. Treatment of lactose intolerance should involve reduction of lactose intake rather than exclusion or even enzyme replacement for primary adult lactase deficiency, which has many available diagnostic tests characterized by different principles, availability, sensitivity, specificity, and cost (50,51,80,84,86,88) . Finally, in spite of the controversies, small Intestine Bacterial Overgrowth (SIBO) should always be considered as a differential diagnosis in patients with IBS, since the reported prevalence of SIBO in patients with IBS is generally high, varying from 4% to 64% and involving mainly patients with IBS-D.…”

Section: Iv-clinical and Therapeutic Aspects Of Ibs And Ncgs Overlapmentioning

confidence: 99%

“…Finally, in spite of the controversies, small Intestine Bacterial Overgrowth (SIBO) should always be considered as a differential diagnosis in patients with IBS, since the reported prevalence of SIBO in patients with IBS is generally high, varying from 4% to 64% and involving mainly patients with IBS-D. Some studies report that treatment with SIBO seems to be associated with improvement of symptoms in patients with IBS who associate them with food intolerance (80,83,85,86,88) .…”

Section: Iv-clinical and Therapeutic Aspects Of Ibs And Ncgs Overlapmentioning

confidence: 99%

“…However, nutritional counseling requires additional financial resources and not all patients will benefit (77,78,79,83) . Dietrich et al (80) analyzed the effect of a low FODMAPs versus a glutenfree diet (GFD) on clinical symptoms, psychological well-being, intestinal inflammation and intestinal integrity and microbiota in NGCS patients. Their reported that both diets caused microbial shifts in all participants, with a greater variability on genus level and metabolisms groups in NCGS patients.…”

Section: Iv-clinical and Therapeutic Aspects Of Ibs And Ncgs Overlapmentioning

confidence: 99%

See 2 more Smart Citations

Irritable Bowel Syndrome, Food Intolerance and Non- Celiac Gluten Sensitivity. A New Clinical Challenge

Soares

2018

Arq. Gastroenterol.

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Approximately 80% of irritable bowel syndrome (IBS) patients report that their symptoms are triggered after ingesting one or specific food groups. Gluten, wheat and related proteins (e.g., amylase-trypsin inhibitors, and fermentable oligo-di-mono-saccharides and polyols (FODMAPs) are the most relevant IBS symptom triggers, although the true ‘culprit(s)’ is/are still not well established. The concept of causal relationship between gluten intake and the occurrence of symptoms in the absence of celiac disease and wheat allergy was termed non-celiac gluten sensitivity (NCGS). The borderline between celiac disease, wheat allergy, IBS and NCGS is not always clearly distinguishable, and the frequency and clinical identity of NGCS are still unclear. An overlap between IBS and NCGS has been detected. The incomplete knowledge of the etiopathogenesis of these clinical conditions, lack of data on their real epidemiology, as well as the absence of a gold standard for their diagnosis, make the overall picture difficult to understand “It is crucial to well define the interaction between IBS, food intolerance and NGCS, since the role of diet in IBS and its dietary management is an essential tool in the treatment of a large number of these patients”. The objective of the present review is to provide an overview highlighting the interaction between IBS, food intolerance and NCGS in order to unravel whether gluten/wheat/FODMAP sensitivity represents ‘facts’ and not ‘fiction’ in IBS symptoms.

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Non-pharmacological Management (Hydration, Diet and Compression)

Eftekhari

Bruce

2020

Postural Tachycardia Syndrome

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Influence of low FODMAP and gluten-free diets on disease activity and intestinal microbiota in patients with non-celiac gluten sensitivity

Cited by 98 publications

References 38 publications

Recent advances in understanding non-celiac gluten sensitivity

Recent advances in understanding non-celiac gluten sensitivity

Irritable Bowel Syndrome, Food Intolerance and Non- Celiac Gluten Sensitivity. A New Clinical Challenge

Non-pharmacological Management (Hydration, Diet and Compression)

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