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      Non-celiac gluten sensitivity: a work-in-progress entity in the spectrum of wheat-related disorders.

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          Abstract

          Non-celiac gluten sensitivity is an undefined syndrome with gastrointestinal and extra-intestinal manifestations triggered by gluten in patients without celiac disease and wheat allergy. The pathogenesis involves immune-mediated mechanisms requiring further research. Symptoms disappear in a few hours or days after gluten withdrawal and recur rapidly after gluten ingestion. Besides gluten, other wheat proteins as well as fermentable oligo-, di-, mono-saccharides and polyols (FODMAPs) may contribute to this syndrome. This syndrome occurs mainly in young women, being rare in children. Its prevalence ranges from 0.6% to 6%, based on primary or tertiary care center estimates. No biomarker is available, but half of patients tests positive for IgG anti-gliadin antibodies, which disappear quickly after gluten-free diet together with symptoms. Also, genetic markers are still undefined. Although currently limited to a research setting, double-blind, placebo-controlled, cross-over trial strategy is recommended to confirm the diagnosis. Treatment is based on dietary restriction with special care to nutrient intake.

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          Author and article information

          Journal
          Best Pract Res Clin Gastroenterol
          Best practice & research. Clinical gastroenterology
          1532-1916
          1521-6918
          Jun 2015
          : 29
          : 3
          Affiliations
          [1 ] Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. Electronic address: umberto.volta@aosp.bo.it.
          [2 ] Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. Electronic address: gpi.caio@gmail.com.
          [3 ] Department of Medical and Surgical Sciences, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. Electronic address: roberto.degiorgio@unibo.it.
          [4 ] Department of Nutrition, University of Oslo, Oslo, Norway. Electronic address: Christine.henriksen@medisin.uio.no.
          [5 ] Department of Gastroenterology, Oslo University Hospital Rikshospitalet, Oslo, Norway. Electronic address: gry.skodje@ous-hf.no.
          [6 ] Department of Gastroenterology, Oslo University Hospital Rikshospitalet, Oslo, Norway; Centre for Immune Regulation, University of Oslo, Oslo, Norway. Electronic address: knut.lundin@medisin.uio.no.
          Article
          S1521-6918(15)00053-0
          10.1016/j.bpg.2015.04.006
          26060112
          1b30465f-0663-4155-9157-d10b487ed6bf
          Copyright © 2015 Elsevier Ltd. All rights reserved.
          History

          Anti-gliadin antibodies,Celiac disease,Duodenal biopsy,Innate/adaptive immunity,Irritable bowel syndrome,Wheat allergy

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