Abstract
Non-Celiac Gluten (Wheat) Sensitivity is a syndrome characterized by intestinal and extra-intestinal symptoms in subjects consuming food made from wheat, barley and rye. Given the lack of a appropriate biomarker, Non-Celiac Gluten (Wheat) Sensitivity is currently a diagnosis of exclusion, mainly exclusion of celiac disease and wheat allergy.
A full diagnostic procedure should involve rapid improvement of symptoms after gluten-free diet and clear worsening shortly after iniciation a gluten challenge. The increased prevalence of gluten-related disorders is hypothesized to be connected with the use of processed cereal-based foods.
The pathogenesis is likely linked to activation of the intestinal and extraintestinal innate immune system. Besides the gluten, cereal amylase-trypsin inhibitors have been identified as the most likely triggers of NCWS.
Moreover, carbohydrates termed FODMAPs (fermentable oligi-, di-, monosaccharides and polyols) could be responsible for gastrointestinal symptoms such as bloating or diarrhoea.