A recent prospective study (A Carrocio et al. Gastroenterol 2019; 17: 682-90) with 78 patients who were diagnosed with “nonceliac gluten or wheat sensitivity” (NCGWS) by double-blind challenge had duodenal and rectal biopsies collected and analyzed. More commonly NCGWS is referred to as NCGS.

Key findings:

• Duodenal tissues from patients with NCGWS had hihger numbers of eosinophils than non-NCGWS controls as did rectal mucosa.  Other elevated markers included epithelial CD3+ T cells, and lamina proppria CD45+ cells.
• Rectal mean eosinophil infiltrations was more than 2.5-fold the upper limit of normal and it was almost 2-fold increased in the duodenum.
• Sensitivity and specificity of rectal eosionphilia, defined by >9 eos in the lamina propria) was 94% and 70% respectively.

My take: This study is intriguing but needs more confirmation. Overall, it appears that the frequency of NCGS is very low.

Related blog posts:

• The latest on Pediatric Nonceliac Gluten Sensitivity
• What Happens When Patients with Nonceliac gluten sensitivity are Challenged with Gluten?
• Is a Gluten-Free Diet a Healthy Diet for those without Celiac Disease?
• An Unexpected Twist for “Gluten Sensitivity” | gutsandgrowth
• The Science Behind IBS Dietary Interventions | gutsandgrowth
• Gluten sensitivity without celiac disease | gutsandgrowth

Synagogue of Santa María la Blanca. Toledo Spain