A new global-scale study has revealed a concerning trend: one in ten people complain of discomfort caused by gluten or wheat, despite not having confirmed celiac disease or allergy. This condition is called Non-Celiac Gluten/Wheat Sensitivity (NCGWS). This poses a complex challenge for doctors and patients, as its underlying causes are not fully understood, and there are no specific diagnostic markers. Research published in the journal Gut provides important information about the prevalence of NCGWS in the global population and the main complaints reported by patients.
NCGWS is defined by a clinical picture of symptoms that appear after consuming gluten or wheat, disappear when these foods are removed from the diet, and reappear when consumption is resumed. A necessary condition is the exclusion of celiac disease or wheat allergy. Symptoms are diverse: they include gastrointestinal problems (e.g., bloating, abdominal pain, diarrhea) and extra-intestinal complaints (e.g., chronic fatigue, headaches, joint pain). Since the biological mechanisms of this condition are still unclear, the diagnosis is mainly made by excluding other possible diseases.
This systematic review is based on data from 25 studies and includes nearly 50,000 participants from 16 countries across five World Health Organization regions. As a result, the self-reported overall prevalence of NCGWS is approximately 10.3%. However, sharp geographical differences were noted: the rate ranges from 0.7% (Chile) to 36% (Saudi Arabia). Prevalence is noticeably higher in high-income countries and among women, who reported symptoms characteristic of this condition twice as often as men.
The study also found a strong link between NCGWS and psychosocial factors (such as anxiety, depression) and Irritable Bowel Syndrome (IBS). Nearly 28% of individuals with NCGWS reported IBS-like symptoms, which was 4.5 times higher compared to the control group. This indicates that psychological factors, including the nocebo effect (the opposite of the placebo effect), play a crucial role in the manifestation of symptoms and may be a kind of triggering mechanism for many cases related to gluten sensitivity.
Despite the lack of clear diagnostic criteria for NCGWS, almost 40% of individuals with self-reported sensitivity switch to a gluten-free diet. This often happens without an official diagnosis or a doctor’s advice. This reflects increasing public awareness but causes concern about unnecessary dietary restrictions, possible nutritional deficiencies, and psychological pressure. Clinicians are urged to evaluate patients in detail, definitively exclude other diseases, and focus on broader biopsychosocial factors, including disorders of the gut-brain interaction, when managing symptoms.
Source: BMJ
