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Dr. Schär Institute

Prevalence of non-coeliac gluten sensitivity

Estimated prevalence of non-coeliac gluten sensitivity (NCGS) varies between 1% and 13% of the population, and as such may be higher than the prevalence of coeliac disease. Unreported cases are likely to be at a similarly high level to coeliac disease [1].
Research indicates that NCGS is probably more prevalent than coeliac disease. Until now, however, there has been a lack of extensive epidemiological studies to verify estimated prevalence of this condition. Clinic data from the Center for Celiac Research, University of Maryland, showed that 6% of the 9,000 patients treated there between 2004-2010 met the criteria for NCGS and complained of corresponding symptoms, without having coeliac disease or wheat allergy [2]. In a recent UK study 13% of a general population sample reported symptoms attributed to gluten [3].
  1. Aziz I, Hadjivassiliou M, Sanders DS.The spectrum of noncoeliac gluten sensitivity. Nat Rev Gastroenterol Hepatol. 2015 Epub ahead of print
  2. Sapone A, Bai JC, Ciacci C et al. Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Med 2012; 10: 13.
  3. Aziz, I. et al. A UK study assessing the population prevalence of self-reported gluten sensitivity and referral characteristics to secondary care. Eur. J. Gastroenterol. Hepatol. 26, 33–39 (2014).

Further information on this topic

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Systematic review: non coeliac gluten sensitivity

Non coeliac gluten sensitivity (NCGS) is a controversial emerging disorder. Despite reported symptoms related to the ingestion of gluten, NCGS remains a diagnosis based on the exclusion of coeliac disease, given the absence of reliable biomarkers.

To evaluate the prevalence, diagnostic exclusion of coeliac disease and the efficacy of a gluten-free diet (GFD) for NCGS patients.

A PubMed search was performed up to December 2014. According to consensus diagnostic criteria, NCGS was defined as self-reported gluten intolerance, negative coeliac serology and absence of villous atrophy. Studies evaluating the impact of a GFD on patients with irritable bowel syndrome (IBS) were also included.

Prevalence rates of NCGS (0.5–13%) differed widely. Seventeen studies, including 1561 patients (26 children), met the inclusion criteria for NCGS. HLA haplotypes could not be linked to histology [normal or lymphocytic enteritis (LE)] in 1123 NCGS patients. HLADQ2/DQ8 haplotypes were present in 44% of NCGS patients. After advanced diagnostic techniques in 189 NCGS patients combining LE and HLADQ2/DQ8 haplotypes, 39 (20%) were reclassified as coeliac disease. There was a higher than expected family history of coeliac disease and autoimmune disorders in NCGS patients. A GFD resulted in variable results for variable, but significantly improved stool frequency in HLADQ2 positive diarrhoea-predominant IBS patients.

Prevalence rates for NCGS are extremely variable. A subset of NCGS patients might belong in the so-called ‘coeliac-lite’ disease. The benefit of a GFD for NCGS patients is currently controversial. HLADQ2 positive diarrhoea- type IBS patients might gain symptom improvement from a GFD.

Resource: Aliment Pharmacol Ther. 2015 May;41(9):807-20. doi: 10.1111/apt.13155. Epub 2015 Mar 6.

Molina-Infante J, Santolaria S, Sanders DS, Fernández-Bañares F.
2015 April

What is the prevalence of Gluten Sensitivity?

International Expert Meeting on Gluten Sensitivity 2012 in Munich, Germany