Non-Celiac Gluten Sensitivity

Do you have non-celiac gluten sensitivity?

You may be one of the millions of people who don't have celiac disease, but know that gluten bothers your system.

I don’t have celiac disease but I am sensitive to gluten. What do I have?

What is non-celiac gluten sensitivity?

How and why does NCGS occur?

What are the symptoms of NCGS?

Gastrointestinal symptoms ^2,4
- Bloating
- Abdominal pain/cramps
- Bowel movements: Diarrhea, constipation or alternating
- Nausea
- Vomiting
- Gastro-esophageal reflux

Extra-gastrointestinal symptoms
(symptoms outside the gut) ^2,4
- Oral lesion: canker sores
- Fatigue
- Headache
- Anxiety
- Foggy mind
- Arm/leg numbness
- Muscle/joint pain
- Weight loss
- Skin rash

*Remember these symptoms can be similar to those of celiac disease.

What should I do?

Is there a treatment for NCGS?

The cornerstone treatment for NCGS is the gluten-free die.4,5 Your doctor or dietitian will assess your vitamin and mineral needs and may recommend gluten-free supplements.
While you may not face all of the same vitamin and mineral deficiencies that often occur with celiac disease, if your diet is limited by even one food group, you can be missing important nutrients.
A Few Examples:

Calcium and Vitamin D if you have lactose intolerance
Most of the B vitamins if you are not eating a variety of gluten-free grains, nuts and seeds
Fiber - it's common knowledge that very few people get enough fiber in their diets.

Recommendations:

Do not diagnose yourself with NCGS or celiac disease. A gastroenterologist will help you make a correct diagnosis.
Do not start a gluten-free diet if you suspect NCGS. You must be tested while still eating gluten to determine the correct diagnosis.
It is highly recommended to schedule a visit with a registered dietitian to gain knowledge about the gluten-free diet.

References:

McAllister BP, Williams E, Clarke K. A comprehensive review of celiac disease/gluten-sensitive enteropathies. Clin Rev Allergy Immunol [Internet]. 2018 Jun 2
Igbinedion SO, Ansari J, Vasikaran A, Gavins FN, Jordan P, Boktor M, et al. Non-celiac gluten sensitivity: All wheat attack is not celiac. World J Gastroenterol. 2017 Oct 28;23(40):7201–10.
Casella G, Villanacci V, Di Bella C, Bassotti G, Bold J, Rostami K. Non celiac gluten sensitivity and diagnostic challenges. Gastroenterol Hepatol Bed Bench. 2018;11(3):197–202.
Bardella MT, Elli L, Ferretti F. Non celiac gluten sensitivity. Curr Gastroenterol Rep. 2016 Dec 1;18(12):63.
Leonard MM, Sapone A, Catassi C, Fasano A. Celiac disease and non-celiac gluten sensitivity: a review. JAMA. 2017 Aug 15;318(7):647–56.

Revision Date: September 11, 2018
Author: Rafael Mendo-Lopez MD
Editors: Melinda Dennis, MS, RDN, LD and Katherine Germansky MD
Prior Revision Date: 11-13-13

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