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Open Access Highly Accessed Commentary

Non-celiac gluten sensitivity - why worry?

Knut E A Lundin

Author Affiliations

Department of Gastroenterology, Oslo University Hospital Rikshospitalet, N-0498 Oslo, Norway

Centre for Immune Regulation, University of Oslo, N-0316 Oslo, Norway

Faculty of Medicine, University of Oslo, N-0316 Oslo, Norway

BMC Medicine 2014, 12:86  doi:10.1186/1741-7015-12-86

Published: 23 May 2014


Wheat, once thought to be a critical ingredient in a healthy diet, has become a major threat, according to public opinion. The term non-celiac gluten sensitivity has been widely adopted to describe a clinical entity characterized by symptoms induced by gluten without the diagnostic criteria found in other gluten-related disorders. However, it has not been shown that gluten per se is involved, and it can be debated if the condition is a disease. Nevertheless, a large number of individuals go gluten-free, avoiding wheat, rye and barley, even without a defined medical cause. In a study in BMC Medicine, Volta and colleagues from Italy report on a large, multicenter attempt to enumerate the prevalence of non-celiac gluten sensitivity in secondary gastroenterology care. They found that approximately 3% of their more than 12,000 patients fulfilled their criteria for non-celiac gluten sensitivity. However, we are still challenged with finding stricter clinical criteria for the condition, developing a usable clinical approach for gluten challenge in these individuals, and understanding the pathogenesis of the condition.

Please see related article webcite.

Celiac disease; Diagnosis; FODMAP; Gluten; Gluten-free diet; Irritable bowel syndrome; Multicenter study; Non-celiac gluten sensitivity