NON-CELIAC GLUTEN SENSITIVITY: A TRADITIONAL REVIEW
Year 2025,
Volume: 7 Issue: 2, 86 - 94, 25.08.2025
Cansu Memiç İnan
,
Ceren Şarahman Kahraman
,
Mustafa Çapraz
Abstract
Non-celiac gluten sensitivity (NCGS) is a disorder characterized by gastrointestinal and extra-intestinal symptoms caused by the consumption of gluten-containing foods in individuals who do not have celiac disease or wheat allergy. The limited knowledge regarding NCGS has led to various challenges in diagnosis and disease management. Due to the lack of sensitive and reproducible biomarkers for diagnosis, current evidence on NCGS prevalence is primarily based on survey studies. Although it is believed that both innate and adaptive immune systems play a role in the pathogenesis of NCGS, this remains an area of uncertainty. A gluten-free diet is recommended as the best treatment method for symptom control in NCGS. However, the gluten-free diet may lead to deficiencies in certain macro and micronutrients, and thus should be followed under the supervision of a nutritionist and clinician. With the continuously evolving body of knowledge, significant progress has been made in understanding the perspective on NCGS. The aim of this review is to provide a comprehensive overview of the etiopathogenesis, clinical features, and treatment of NCGS considering the most recent data.
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NON-ÇÖLYAK GLUTEN HASSASİYETİ: GELENEKSEL BİR DERLEME
Year 2025,
Volume: 7 Issue: 2, 86 - 94, 25.08.2025
Cansu Memiç İnan
,
Ceren Şarahman Kahraman
,
Mustafa Çapraz
Abstract
Non-çölyak gluten hassasiyeti (NCGS), çölyak hastalığı veya buğday alerjisi olmayan bireylerde, gluten içeren besinlerin tüketimi ile gastrointestinal ve ekstraintestinal semptomlara neden olan bir bozukluktur. NCGS’ye ilişkin bilgilerin oldukça sınırlı olması, tanı koymada ve hastalık yönetiminde çeşitli zorluklara neden olmaktadır. Tanı için duyarlı ve tekrarlanabilir biyobelirteçlerin eksikliği nedeni ile NCGS prevalansını belirlenmeye yönelik mevcut kanıtlar anket çalışmalarına dayanmaktadır. NCGS patogenezinde doğuştan gelen ve adaptif bağışıklık sisteminin etkili olduğu düşünülmekle birlikte bu durum henüz netliğe kavuşturulmamıştır. NCGS’de semptomların kontrolü için en iyi tedavi yöntemi olarak glutensiz diyet önerilmektedir. Glutensiz diyet, bazı makro ve mikro besin ögelerinde eksikliklere neden olabilir bu nedenle beslenme uzmanı ve klinisyen kontrolünde yürütülmelidir. Sürekli güncellenen bilgiler ile NCGS’ye ait bakış açısında ilerleme kaydedilmektedir. Bu derleme çalışmasının amacı ise güncel bilgiler ışığında NCGS’nin etiyopatolojisi, klinik özelliklerinin daha iyi anlaşılması ve tedavisine yönelik genel bir bakış açısı sunmaktır.
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Abdi, F., Zuberi, S., Blom, J. J., Armstrong, D., & Pinto-Sanchez, M. I. (2023). Nutritional Considerations in Celiac Disease and Non-Celiac Gluten/Wheat Sensitivity. Nutrients, 15(6), 1475. Doi: 10.3390/nu15061475
-
Al-Toma, A., Volta, U., Auricchio, R., Castillejo, G., Sanders, D. S., Cellier, C., Mulder, C. J., & Lundin, K. E. A. (2019). European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European gastroenterology journal, 7(5), 583–613. doi: 10.1177/2050640619844125
-
Amirikian, K., Sansotta, N., Guandalini, S., & Jericho, H. (2019). Effects of the Gluten-free Diet on Body Mass Indexes in Pediatric Celiac Patients. Journal of pediatric gastroenterology and nutrition, 68(3), 360–363. doi: 10.1097/MPG.0000000000002190
-
Barbaro, M.R., Cremon, C., Stanghellini, V., & Barbara, G. (2018). Recent advances in understanding non-celiac gluten sensitivity. F1000Research,7.doi:10.12688/f1000research.15849.1
Barbaro, M.R., Cremon, C., Wrona, D., Fuschi, D., Marasco, G., Stanghellini, V., & Barbara, G. (2020). Non-celiac gluten sensitivity in the context of functional gastrointestinal disorders. Nutrients, 12(12), 3735. doi: 10.3390/nu12123735
-
Bellini, M., Tonarelli, S., Nagy, A.G., Pancetti, A., Costa, F., Ricchiuti, A., ... & Rossi, A. (2020). Low FODMAP diet: evidence, doubts, and hopes. Nutrients, 12(1), 148. doi: 10.3390/nu12010148
Cabanillas, B. (2020). Gluten-related disorders: Celiac disease, wheat allergy, and nonceliac gluten sensitivity. Critical reviews in food science and nutrition, 60(15), 2606-2621. doi: 10.1080/10408398.2019.1651689
-
Cárdenas-Torres, F.I., Cabrera-Chávez, F., Figueroa-Salcido, O.G., & Ontiveros, N. (2021). Non-celiac gluten sensitivity: an update. Medicina, 57(6), 526. doi: 10.3390/medicina57060526
-
Cardo, A., Churruca, I., Lasa, A., Navarro, V., Vázquez-Polo, M., Perez-Junkera, G., & Larretxi, I. (2021). Nutritional imbalances in adult celiac patients following a gluten-free diet. Nutrients, 13(8), 2877. doi: 10.3390/nu13082877
-
Carroccio, A., D’Alcamo, A., Iacono, G., Soresi, M., Iacobucci, R., Arini, A., ... & Mansueto, P. (2017). Persistence of nonceliac wheat sensitivity, based on long-term follow-up. Gastroenterology, 153(1), 56-58. doi: 10.1053/j.gastro.2017.03.034
-
Castillo-Rodal, A.I., Furuzawa-Carballeda, J., Peláez-Luna, M., Castro-Gómez, J., López-Vidal, Y., & Uscanga, L. (2020). More fuel to the fire: some patients with non-celiac self-reported wheat sensitivity exhibit adaptive immunological responses in duodenal mucosa. BMC gastroenterology, 20, 1-13. doi: 10.1186/s12876-020-01564-w
-
Catassi, C., Elli, L., Bonaz, B., Bouma, G., Carroccio, A., Castillejo, G., ... & Fasano, A. (2015). Diagnosis of non-celiac gluten sensitivity (NCGS): the Salerno experts’ criteria. Nutrients, 7(6), 4966-4977. doi: 10.3390/nu7064966
-
Catassi, C., Verdu, E. F., Bai, J. C., & Lionetti, E. (2022). Coeliac disease. Lancet (London, England), 399(10344), 2413–2426. Doi: 10.1016/S0140-6736(22)00794-2
-
Ciccone, A., Gabrieli, D., Cardinale, R., Di Ruscio, M., Vernia, F., Stefanelli, G., Necozione, S., Melideo, D., Viscido, A., Frieri, G., & Latella, G. (2019). Metabolic Alterations in Celiac Disease Occurring after Following a Gluten-Free Diet. Digestion, 100(4), 262–268. doi: 10.1159/000495749
-
Cooper, B. T., Holmes, G. K., Ferguson, R., Thompson, R. A., Allan, R. N., & Cooke, W. T. (1980). Gluten-sensitive diarrhea without evidence of celiac disease. Gastroenterology, 79(5 Pt 1), 801–806.
-
Di Nardo, G., Villa, M.P., Conti, L., Ranucci, G., Pacchiarotti, C., Principessa, L., ... & Parisi, P. (2019). Nutritional deficiencies in children with
celiac disease resulting from a gluten-free diet: a systematic review. Nutrients, 11(7), 1588. doi: 10.3390/nu11071588
-
Efthymakis, K., Clemente, E., Marchioni, M., Di Nicola, M., Neri, M., & Sallese, M. (2020). An exploratory gene expression study of the intestinal mucosa of patients with non-celiac wheat sensitivity. International Journal of Molecular Sciences, 21(6), 1969. doi: 10.3390/ijms21061969
-
Fernandes Dias, L. B. A., Kobus, R. A., & Bagolin do Nascimento, A. (2023). Effectiveness of the low-FODMAP diet in improving non-celiac gluten sensitivity: a systematic review. The British journal of nutrition, 129(12), 2067–2075. doi: 10.1017/S0007114522002884
-
Herrera, M.G., Pizzuto, M., Lonez, C., Rott, K., Hütten, A., Sewald, N., ... & Dodero, V.I. (2018). Large supramolecular structures of 33-mer gliadin peptide activate toll-like receptors in macrophages. Nanomedicine: Nanotechnology, Biology and Medicine, 14(4), 1417-1427. doi: 10.1016/j.nano.2018.04.014
-
Husby, S., Koletzko, S., Korponay-Szabó, I., Kurppa, K., Mearin, M.L., Ribes-Koninckx, C., ... & Wessels, M. (2020). European society paediatric gastroenterology, hepatology and nutrition guidelines for diagnosing coeliac disease 2020. Journal of pediatric gastroenterology and nutrition, 70(1), 141-156. doi: 10.1097/MPG.0000000000002497
-
Jivraj, A., Hutchinson, J.M., Ching, E., Marwaha, A., Verdu, E.F., Armstrong, D., & Pinto-Sanchez, M.I. (2022). Micronutrient deficiencies are frequent in adult patients with and without celiac disease on a gluten-free diet, regardless of duration and adherence to the diet. Nutrition, 103, 111809. doi: 10.1016/j.nut.2022.111809
-
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