title: Nonceliac gluten sensitivity.
abstract: During the past decade there has been an impressive increase in popularity of the gluten-free diet (GFD)-now the most trendy alimentary habit in the United States and other countries. According to recent surveys, as many as 100 million Americans will consume gluten-free products within a year. Operating under the concept that the GFD benefits only individuals with celiac disease, health care professionals have struggled to separate the wheat from the chaff; there are claims that eliminating gluten from the diet increases health and helps with weight loss, or even that gluten can be harmful to every human being. However, apart from unfounded trends, a disorder related to ingestion of gluten or gluten-containing cereals, namely nonceliac gluten sensitivity (NCGS), has resurfaced in the literature, fueling a debate on the appropriateness of the GFD for people without celiac disease. Although there is clearly a fad component to the popularity of the GFD, there is also undisputable and increasing evidence for NCGS. However, we require a better understanding of the clinical presentation of NCGS, as well as its pathogenesis, epidemiology, management, and role in conditions such as irritable bowel syndrome, chronic fatigue, and autoimmunity. Before we can begin to identify and manage NCGS, there must be agreement on the nomenclature and definition of the disorder based on proper peer-reviewed scientific information. We review the most recent findings on NCGS and outline directions to dissipate some of the confusion related to this disorder.
authors.affiliation: Mucosal Immunology and Biology Research Center and Center for Celiac Research, Massachusetts General Hospital for Children, Harvard Medical School, Boston, Massachusetts. Electronic address: afasano@mgh.harvard.edu.
authors.forename: Alessio
authors.initials: A
authors.lastname: Fasano
authors.affiliation: Mucosal Immunology and Biology Research Center and Center for Celiac Research, Massachusetts General Hospital for Children, Harvard Medical School, Boston, Massachusetts; Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Anna
authors.initials: A
authors.lastname: Sapone
authors.affiliation: Institute of Translational Immunology and Research Center for Immunotherapy, University of Mainz Medical Center, Mainz, Germany.
authors.forename: Victor
authors.initials: V
authors.lastname: Zevallos
authors.affiliation: Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Institute of Translational Immunology and Research Center for Immunotherapy, University of Mainz Medical Center, Mainz, Germany.
authors.forename: Detlef
authors.initials: D
authors.lastname: Schuppan
mesh_terms: D000485:Allergens / Q000009:adverse effects*; D000595:Amino Acid Sequence; D000818:Animals; D002446:Celiac Disease / Q000145:classification / Q000175:diagnosis / Q000178:diet therapy / Q000453:epidemiology / Q000276:immunology*; D004032:Diet / Q000009:adverse effects*; D055050:Diet, Gluten-Free; D005247:Feeding Behavior; D005512:Food Hypersensitivity / Q000145:classification / Q000175:diagnosis / Q000178:diet therapy / Q000453:epidemiology / Q000276:immunology*; D005983:Glutens / Q000009:adverse effects*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000145:classification / Q000175:diagnosis / Q000178:diet therapy / Q000453:epidemiology / Q000276:immunology*; D008969:Molecular Sequence Data; D011237:Predictive Value of Tests; D012307:Risk Factors; D009626:Terminology as Topic; D016896:Treatment Outcome
chemical_list: D000485:Allergens; D005983:Glutens
keywords: Allergy; Celiac Disease; FODMAP; Food; Gluten; IBS; Sensitivity; Wheat