Prevalence and Characterization of Self-Reported Gluten Sensitivity in The Netherlands

Gils, Tom van; Nijeboer, Petula; IJssennagger, C E; Sanders, David S.; Mulder, Chris J.; Bouma, Gerd

doi:10.3390/nu8110714

Cited by 77 publications

(85 citation statements)

References 31 publications

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“…9 This is in line with similar studies from the US, Chile, United Kingdom and Europe that demonstrated a population prevalence of self-reported wheat or gluten sensitivity of between 4% and 13%. [9][10][11][12][13][14] This suggests that a gluten-sensitive condition, separate to coeliac disease and wheat allergy, may be responsible for their symptoms. This condition has attracted increasing international attention and has been labelled non-coeliac gluten sensitivity.…”

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confidence: 99%

Non‐coeliac gluten or wheat sensitivity: emerging disease or misdiagnosis?

Potter

Walker

Talley

2017

Medical Journal of Australia

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Non-coeliac gluten or wheat sensitivity (NCG/WS) is a condition characterised by adverse gastrointestinal and/or extra-intestinal symptoms associated with the ingestion of gluten- or wheat-containing foods, in the absence of coeliac disease or wheat allergy. Up to one in 100 people in Australia may have coeliac disease but many more report adverse gastrointestinal and/or extra-intestinal symptoms after eating wheat products. In the absence of validated biomarkers, a diagnosis of NCG/WS can only be made by a double-blind, placebo-controlled, dietary crossover challenge with gluten, which is difficult to apply in clinical practice. Of people self-reporting gluten or wheat sensitivity, only a small proportion (16%) will have reproducible symptoms after a blinded gluten challenge of gluten versus placebo in a crossover dietary trial and fulfil the current consensus criteria for a diagnosis of NCG/WS. A wide range of symptoms are associated with NCG/WS, including gastrointestinal, neurological, psychiatric, rheumatological and dermatological complaints. The pathogenesis of NCG/WS is not well understood, but the innate immune system has been implicated, and there is overlap with coeliac disease and the functional gastrointestinal disorders (irritable bowel syndrome and functional dyspepsia). Identification of NCG/WS is important as gluten-free diets carry risks, are socially restricting and are costlier than regular diets.

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confidence: 99%

Non‐coeliac gluten or wheat sensitivity: emerging disease or misdiagnosis?

Potter

Walker

Talley

2017

Medical Journal of Australia

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“…Over 75% of these patients have HLA-DQ2 and / or HLA-DQ8.75% of these patients carry HLA-DQ2 and/ or HLA-DQ8 (43) . NCGS can be defined to describe individuals who complain of intestinal and extra-intestinal symptoms related to gluten intake and report rapid improvement after withdrawal of these foods from the diet, and in which both the diagnosis of CD and wheat allergy are discarded (45,52,53,58,(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73) . This fact raises many unanswered questions.…”

Section: Iii-gluten Related Disorders -Ncgs and Ibsmentioning

confidence: 99%

“…However, 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 (22,(27)(28)(34)(35)(36)(37)44,45,57,58,(61)(62)(63) . 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 (52,61,63,68,72,73) . In addition, Rome IV criteria seem unable to exclude an underlying possible IBS-like disorder.…”

Section: Iii-gluten Related Disorders -Ncgs and Ibsmentioning

confidence: 99%

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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“…Since specific diagnostic markers are missing, the large majority of data on NCGS are based on patients’ self-reported gluten-induced symptoms. Several studies tried to estimate the prevalence of NCGS: one of the first reports comes from the Center for Celiac Research at the University of Maryland (USA) reporting a prevalence of gluten avoidance of approximately 6% in a population of patients with GI symptoms seen at a tertiary center [9], while other reports indicate a prevalence of 0.5 up to 10% in a general population [10-13]. All studies show a clear predominance of women.…”

Section: Epidemiological Studies On Ncgsmentioning

confidence: 99%

Non-Celiac Gluten Sensitivity: A Challenging Diagnosis in Children with Abdominal Pain

Ruemmele

2018

Ann Nutr Metab

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Several disorders related to the ingestion of gluten are well recognized despite overlapping clinical presentations: celiac disease, an autoimmune enteropathy triggered by gluten ingestions in susceptible individuals, allergy to wheat, and more recently non-celiac gluten sensitivity (NCGS). While celiac disease and wheat allergy are well-known disorders with a clear-cut diagnosis based on clinical tests and biological parameters, NCGS is a more difficult diagnosis, especially in children with functional gastrointestinal (GI) complaints. NCGS is considered a syndrome of intestinal but also extraintestinal symptoms occurring within hours, but sometimes even after several days of gluten ingestion. In children, the leading symptoms of NCGS are abdominal pain and diarrhea, while extraintestinal symptoms are rare, in contrast to adult patients. No precise diagnostic test nor specific biomarkers exist, except a rather cumbersome three-phase gluten-exposure, gluten-free diet, followed by a blinded placebo-controlled gluten challenge with crossover to provoke symptoms elicited by gluten in a reproducible manner that disappear on gluten-free alimentation. Recent data indicate that the peptide part of wheat proteins is not necessarily the sole trigger of clinical symptoms. Mono- or oligosaccharides, such as fructan and other constituents of wheat, were able to provoke GI symptoms in clinical trials. These new findings indicate that the term gluten sensitivity is probably too restrictive. The incidence of NCGS was reported in the range of 1–10% in the general population and to increase steadily; however, most data are based on patients’ self-reported gluten intolerance or avoidance without a medically confirmed diagnosis. Treatment consists of gluten avoidance for at least several weeks or months. Patients with NCGS require regular reassessment for gluten tolerance allowing with time the reintroduction of increasing amounts of gluten.

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Prevalence and Characterization of Self-Reported Gluten Sensitivity in The Netherlands

Cited by 77 publications

References 31 publications

Non‐coeliac gluten or wheat sensitivity: emerging disease or misdiagnosis?

Non‐coeliac gluten or wheat sensitivity: emerging disease or misdiagnosis?

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

Non-Celiac Gluten Sensitivity: A Challenging Diagnosis in Children with Abdominal Pain

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