scholarly journals Non-Celiac Gluten Sensitivity in Children: Controversial Role of Gluten and Diagnostic Enigma

2021 ◽  
Vol 05 (03) ◽  
pp. 1-1
Author(s):  
Chandra Sekhar Devulapalli ◽  
Keyword(s):  
Gold Standard ◽  
Adult Population ◽  
Gastrointestinal Symptoms ◽  
Diagnostic Procedures ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Wheat Allergy ◽  
Personal Experiences ◽  
Standardized Diagnostic

Non-celiac gluten sensitivity (NCGS) is a debatable condition that affects less than 6% of children. The absence of specific diagnostic markers and standardized diagnostic procedures make the diagnosis of NCGS challenging, covering patients with different and varied symptoms. Generally, the parents of small and younger children introduce a gluten-free diet (GFD) based on their personal experiences and expectations. Additionally, a “fad component” exists, contributing to the recent rise in the popularity of GFD. Thus, celiac disease (CD) and wheat allergy (WA) must be excluded as these also appear in individuals experiencing symptoms similar to those of NCGS, improving and worsening with gluten withdrawal and consumption, respectively. The role of gluten inducing gastrointestinal symptoms in individuals with self-reported NCGS has been skeptically assessed based on evidence in recent years. However, currently, it is unknown whether a strict GFD is necessary for patients with NCGS. Thus, the placebo-controlled gluten challenge remains the gold standard for a challenging diagnosis like NCGS. The present review evaluates the published studies based largely on the adult population and describes the key elements in diagnosing NCGS and differential diagnosis with CD and WA.

scholarly journals Non-celiac wheat sensitivity: a search for the pathogenesis of a self-reported condition

2019 ◽  
Vol 13 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Pasquale Mansueto ◽  
Maurizio Soresi ◽  
Rosario Iacobucci ◽  
Francesco La Blasca ◽  
Giulia Romano ◽  
...  
Keyword(s):  
Gastrointestinal Symptoms ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Wheat Allergy ◽  
Allergy Diagnosis ◽  
Double Blind ◽  
Innate And Adaptive Immunity ◽  
Double Blind Placebo ◽  
Wheat Sensitivity

A significant percentage of the general population reports gastrointestinal and non-gastrointestinal symptoms caused by wheat and/or gluten ingestion, even though they do not suffer from celiac disease (CD) or wheat allergy (WS), because they test negative both for CD-specific serology and histopathology. All patients report improvement of symptoms on a gluten-free diet. This clinical condition has been named non-celiac gluten sensitivity (NCGS). The objective of this paper was to review some studies regarding the pathogenesis of NCGS to summarize the current hypotheses about the mechanisms, which can lead to NCGS. Particular attention was given to the immunologic and the malabsorptive hypotheses. We reviewed data of our previous studies involving patients diagnosed with NCWS by means of double-blind placebo-controlled wheat challenge. The data indicating a possible wheat allergy diagnosis were examined and other data in the literature were reviewed; we also reviewed the putative role of fermentable oligosaccharides disaccharides monosaccharides and polyols (FODMAPs) and of α-amylasetrypsin inhibitors (ATIs) proteins in the NCGS pathogenesis. NCGS pathogenesis has been attributed to very different mechanisms, among others: i) activation of innate and adaptive immunity (the immune/allergic mechanisms) induced by gluten or the non-gluten ATI family; ii) incomplete digestion and/or absorption of FODMAPs (the intolerance mechanisms); and iii) psychological effect.We suggest that NCGS is a heterogeneous condition, which includes different subgroups of patients who have different pathogenic mechanisms: strong data suggest a direct pathogenic immunogenic/inflammatory role of wheat-cereal proteins (not only gluten) in a subgroup, probably the largest, of these patients.

scholarly journals The Role of a Low Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyol Diet in Nonceliac Gluten Sensitivity

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
P. Priyanka ◽  
S. Gayam ◽  
J. T. Kupec
Keyword(s):  
Systematic Review ◽  
Celiac Disease ◽  
Wheat Germ ◽  
Clinical Symptoms ◽  
Additional Benefit ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Wheat Allergy ◽  
Fodmap Diet

Background. Nonceliac gluten sensitivity (NCGS) is a recently defined clinical entity characterized by intestinal and extraintestinal symptoms associated with gluten ingestion in individuals in whom celiac disease (CD) or wheat allergy (WA) has been excluded. Despite its name and definition, gluten has been shown to precipitate symptoms in only 16–30% of these patients. In addition to gluten, other components of wheat, including fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs), alpha-amylase trypsin inhibitors (ATIs) and wheat germ agglutinin have been implicated in the causation of the symptoms of NCGS, with FODMAPs garnering the most attention. We present a review of the existing literature evaluating the role of FODMAPs in NCGS symptomatology. Methods. A systematic review of PubMed, Cochrane, EMBASE, and Google Scholar for keywords fructans, non-celiac gluten sensitivity, NCGS, FODMAPs, and gluten-free diet (GFD) was conducted through a series of advanced searches. Articles related to the use of fructans or FODMAPs were analyzed. Results. FODMAPs were found to be associated with gastrointestinal and extraintestinal symptoms in NCGS. Conclusions. A low FODMAP diet has potential for improvement of clinical symptoms in NCGS. In addition, some evidence suggests an additional benefit to simultaneous adherence to both low FODMAP diet and GFD.

scholarly journals Gluten and Functional Abdominal Pain Disorders in Children

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1491 ◽  
Author(s):  
Alejandro Llanos-Chea ◽  
Alessio Fasano
Keyword(s):  
Abdominal Pain ◽  
Pediatric Patients ◽  
Functional Gastrointestinal Disorders ◽  
Gastrointestinal Symptoms ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Functional Abdominal Pain ◽  
Adults And Children ◽  
Small Intestinal ◽  
Irritable Bowel

In children, functional gastrointestinal disorders (FGIDs) are common at all ages. Consumption of certain foods, particularly gluten, is frequently associated with the development and persistence of FGIDs and functional abdominal pain disorders (FAPDs) in adults and children. However, this association is not well defined. Even without a diagnosis of celiac disease (CD), some people avoid gluten or wheat in their diet since it has been shown to trigger mostly gastrointestinal symptoms in certain individuals, especially in children. The incidence of conditions such as non-celiac gluten sensitivity (NCGS) is increasing, particularly in children. On the other hand, CD is a chronic, autoimmune small intestinal enteropathy with symptoms that can sometimes be mimicked by FAPD. It is still unclear if pediatric patients with irritable bowel syndrome (IBS) are more likely to have CD. Abdominal, pain-associated FGID in children with CD does not seem to improve on a gluten-free diet. The threshold for gluten tolerance in patients with NCGS is unknown and varies among subjects. Thus, it is challenging to clearly distinguish between gluten exclusion and improvement of symptoms related solely to functional disorders.

scholarly journals Dermatomyositis Associated with Celiac Disease: Response to a Gluten-Free Diet

2006 ◽  
Vol 20 (6) ◽  
pp. 433-435 ◽  
Author(s):  
Min Soo Song ◽  
David Farber ◽  
Alain Bitton ◽  
Jeremy Jass ◽  
Michael Singer ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Adult Population ◽  
Gastrointestinal Symptoms ◽  
Human Leukocyte ◽  
Gluten Free Diet ◽  
Nutritional Deficiencies ◽  
Deficiency Anemia ◽  
Gluten Free ◽  
Disease Response ◽  
Vitamin Deficiencies

The association between dermatomyositis and celiac disease in children has been well documented. In the adult population, however, the association has not been clearly established. A rare case of concomitant dermatomyositis and celiac disease in a 40-year-old woman is presented. After having been diagnosed with dermatomyositis and iron deficiency anemia, this patient was referred to the gastroenterology clinic to exclude a gastrointestinal malignancy. Blood tests revealed various vitamin deficiencies consistent with malabsorption. The results of gastroscopy with duodenal biopsy were consistent with celiac disease. After she was put on a strict gluten-free diet, both nutritional deficiencies and the dermatomyositis resolved. The patient’s human leukocyte antigen haplotype study was positive for DR3 and DQ2, which have been shown to be associated with both juvenile dermatomyositis and celiac disease. It is suggested that patients with newly diagnosed dermatomyositis be investigated for concomitant celiac disease even in the absence of gastrointestinal symptoms.

scholarly journals The impact of gluten ingestion on pathogenesis of neurological disorders

2019 ◽  
Vol 73 ◽  
pp. 197-216
Author(s):  
Piotr Grzegrzółka ◽  
Robert Jarzyna
Keyword(s):  
Autism Spectrum Disorder ◽  
Nervous System ◽  
Celiac Disease ◽  
Human Body ◽  
Neurological Disorders ◽  
Gastrointestinal Symptoms ◽  
Autism Spectrum ◽  
Gluten Sensitivity ◽  
Wheat Allergy ◽  
The Impact

For many years the spectrum of gluten-related disorders had been limited only to celiac disease and its typical gastrointestinal symptoms. In the last few years, not only new disorders like non-celiac gluten sensitivity have been described, but also pathogeneses of celiac disease and wheat allergy have been better understood. It is also known that impaired gluten tolerance in many cases leads to appearance of extraintestinal symptoms that may affect any organ or system of the human body including the nervous system that may be the cause of some neurological disorders such as ataxia, neuropathy, autism spectrum disorder (ASD) or schizophrenia. In this paper we present the spectrum of neurological disorders, whose pathogeneses may depend on gluten ingestion and some proposed mechanisms elucidating those pathogeneses.

scholarly journals Prevalence of Self-Reported Gluten Sensitivity and Adherence to a Gluten-Free Diet in Argentinian Adult Population

Nutrients ◽  
2017 ◽  
Vol 9 (1) ◽  
pp. 81 ◽  
Author(s):  
Francisco Cabrera-Chávez ◽  
Gimena Dezar ◽  
Anna Islas-Zamorano ◽  
Jesús Espinoza-Alderete ◽  
Marcela Vergara-Jiménez ◽  
...  
Keyword(s):  
Adult Population ◽  
Gluten Free Diet ◽  
Gluten Sensitivity ◽  
Gluten Free

scholarly journals The many faces of the problem of intolerance to gluten.

2018 ◽  
Vol 96 (2) ◽  
pp. 123-128
Author(s):  
M. A. Livsan ◽  
M. F. Osipenko ◽  
Natalya V. Zayakina ◽  
T. S. Krolevets
Keyword(s):  
Celiac Disease ◽  
Dermatitis Herpetiformis ◽  
Current Data ◽  
Gluten Sensitivity ◽  
Wheat Allergy ◽  
Serological Markers ◽  
Gluten Intolerance ◽  
Rising Incidence ◽  
The Many

Rising incidence of different variants of gluten intolerance associated with changes in eating behaviorin many countries, changes in the technology of growing and processing crops, new culinary technologies. Until recently, celiac disease, dermatitis herpetiformis and wheat allergy were the only known disease with a proven role of gluten in their pathogenesis. Non-celiac gluten sensitivity (NCGS) - a new syndrome of intolerance to gluten. This pathology can be suspected in patients with persistent intestinal and extra-intestinal symptoms clearly associated with the intake of foods containing gluten, the absence of serological markers of celiac disease or suspected allergy to wheat. The paper presents the current data on the epidemiology, etiology and pathogenesis, clinical features and diagnosis NCGS.

scholarly journals Assessing of Celiac Disease and Nonceliac Gluten Sensitivity

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
N. Ontiveros ◽  
M. Y. Hardy ◽  
F. Cabrera-Chavez
Keyword(s):  
Celiac Disease ◽  
Healthcare Professionals ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Wheat Allergy ◽  
Exclusion Criteria ◽  
Food Components ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

The publication of papers on the topic of gluten related disorders has substantially increased over the last few years. This has motivated healthcare professionals to pay attention not only to celiac disease and wheat allergy but also to a condition termed nonceliac gluten sensitivity (NCGS). Until now this condition has been diagnosed clinically on the basis of exclusion criteria and clinical response to gluten withdrawal. In addition, recent research in this field has shown that other food components distinct from gluten are implicated in NCGS cases, thereby changing our general understanding of NCGS diagnosis in either individuals on gluten containing diets or those already following a gluten-free diet with no proper diagnostic work-up of celiac disease. With this in mind, the assessment of NCGS will require extensive knowledge of celiac disease manifestations and the laboratory tests commonly performed during diagnosis of celiac disease.

scholarly journals Gluten-Associated Pathology: Focusing on Patients with Irritable Bowel Syndrome

2020 ◽  
Vol 16 (30) ◽  
pp. 66-73
Author(s):  
O.V. Gaus ◽  
◽  
M.A. Livzan ◽  
D.V. Popello
Keyword(s):  
Irritable Bowel Syndrome ◽  
Celiac Disease ◽  
Clinical Symptoms ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Wheat Allergy ◽  
The World ◽  
Wheat Products ◽  
Irritable Bowel ◽  
The Many

Wheat is an essential part of the diet of many people around the world. Despite the many beneficial aspects of eating wheat products, they can be associated with the development of a variety of diseases. The spectrum of gluten-associated pathologies includes celiac disease, wheat allergy, and non-celiac gluten sensitivity (NCGS). The clinical symptoms of gluten-associated pathology are similar to those of irritable bowel syndrome (IBS). Diagnosis of celiac disease and wheat allergy is now straightforward. NCGS remains a diagnosis of exclusion due to the lack of specific biomarkers and standardized research methods. Many patients with IBS consider themselves gluten-sensitive and their symptoms are relieved by a gluten-free diet. Most likely it is NCGS that occurs in a heterogeneous group of patients with IBS. However it remains controversial whether the development of symptoms in this case is associated with gluten itself or with other components of wheat, such as non-gluten proteins and FODMAPs.

Sign in / Sign up

Export Citation Format

Share Document