Abstract
Among adverse food reactions, gluten-related disorders are now gaining more and more space in scientific and non-scientific publications. These disorders are divided into three entities: celiac disease (CD), wheat allergy (WA), and non-celiac sensitivity to gluten or wheat (NCGS), considering that this cereal is associated more frequently with the manifestations, and since it is also discussed whether or not this grain would be the real triggering food component. Celiac disease is an autoimmune enteropathy, whereas WA is a hypersensitive reaction, mediated or not mediated by immunoglobulin E (IgE). Non-celiac sensitivity to gluten or wheat is an emerging entity of pathophysiology still under discussion, which several researchers propose as a diagnosis of exclusion in relation to CD and WA, and it has aroused great popular excitement and controversy in medical circles. The present review aims to approach NCGS, seeking to distinguish elements of the other two disorders, such as clinical characteristics, differential diagnosis, pathophysiology, and treatment. In many studies, the possibility of overlapping or of diagnostic confusion with other functional gastrointestinal diseases, such as irritable bowel syndrome (IBS) and fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs), is highlighted. We conclude that NCGS, although it is a clinical entity recognized by a significant number of researchers, is still widely questioned regarding its characterization, diagnosis and pathophysiology. This, given the high prevalence estimated and the popular repercussions, is undoubtedly a subject worthy of further and well-conducted studies.
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References
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