Resumen de Non-celiac gluten sensitivity
Javier Molina Infante, Santos Santolaria Piedrafita, Fernando Fernández Bañares
Non-celiac gluten sensitivity (NCGS) is a resurfaced emergingdisorder characterized by intestinal and extra-intestinal symptomsrelated to the ingestion of gluten-containing food in subjects notaffected with either celiac disease (CD) or wheat allergy. Despitelacking solid epidemiological data, its prevalence has been estimatedfive to ten-times higher than that of CD and sells from gluten-free foodmarket have rocketed three-fold lately. Unlike CD, NCGS seems to beassociated with activation of the innate immune response. NCGSremains a diagnosis of exclusion of CD, due to the absence ofdiagnostic specific biomarkers. Evolving evidence has pointed thepossibility of a relevant proportion of NGCS in literature actuallysuffering from overlooked minor forms of CD, the so-called “celiac lite”disease. The efficacy of a gluten-free diet for NCGS is controversialand other components in wheat, specially low-fermentable, poorly-absorbed, short-chain carbohydrates have been lately postulated asmajor contributors to symptoms, instead of gluten. This reviewupdates evidence on epidemiology, pathophysiology, diagnosis anddietary interventions in NCGS, stressing the need of thoroughscreening for CD before a diagnosis of NCGS is given, considering thatnatural history and dietary restriction for both entities are radicallydifferent.
