MADRID, Oct. 30 (EUROPA PRESS) –

About one in ten people worldwide report gastrointestinal and other symptoms, such as fatigue and headache, after eating foods containing gluten or wheat despite not having a diagnosis of celiac disease or wheat allergy, according to a large systematic review and meta-analysis from University Hospitals of Leicester NHS (UK) published online in Gut.

Gluten is a protein found in wheat, barley and rye, and is responsible for the elasticity of dough in bread and other baked goods. For most people, gluten is not a problem, but for some, it can trigger adverse reactions that affect digestion and overall well-being.

The celiac disease It is an autoimmune intolerance to gluten: when ingested, the immune system damages the small intestine, causing nutrient malabsorption, diarrhea, fatigue and other serious symptoms. On the other hand, the wheat allergy It involves an immediate response of the immune system to wheat proteins, including gluten, causing everything from hives and swelling to serious respiratory problems.

WHAT IS NON-CELIAC GLUTEN/WHEAT SENSITIVITY?

Additionally, there is a growing group of people who experience symptoms after consuming gluten or wheat. without being celiac or allergicknown as non-celiac gluten/wheat sensitivity (NCGWS)characterized by abdominal pain, bloating, fatigue and general discomfort, which improves by eliminating these foods from the diet.

These people have a condition known as non-celiac gluten/wheat sensitivity (NCGWS), which appears to be more common in women and associated with irritable bowel syndrome, anxiety and depression.

THE SYMPTOMS OF NCGWS

NCGWS symptoms tend to improve when avoiding gluten or wheat and reappear when foods containing them are reintroduced into the diet. However, unlike celiac disease and wheat allergy, the pathological process underlying NCGWS is unclear and there are no associated specific blood markers, making its diagnosis difficult.

Currently, andl NCGWS is diagnosed by excluding celiac disease and allergy to wheat in people who report adverse symptoms after eating gluten or wheat, and little is known about the prevalence and clinical features present.

To address this, the authors identified all studies published between 2014 and 2024 that assessed the prevalence of self-reported NCGWS in the general population. Twenty-five studies, with 49,476 participants from 16 countries, met the inclusion criteria and these data were extracted for pooled analysis.

The data also revealed that four in ten people who reported having NCGWS followed a gluten-free diet to avoid gastrointestinal and other bothersome symptoms, often doing so in the absence of formal medical advice or a diagnosis.

The most common symptoms reported by participants were bloating (71%), abdominal discomfort (46%), abdominal pain (36%), and fatigue (32%). Other reported symptoms included diarrhea, constipation, headache and joint pain.

Additionally, self-reported NCGWS was significantly more common in women and significantly more likely to occur in people who reported anxiety, depression, and irritable bowel syndrome.

CLINICAL IMPLICATIONS

The authors acknowledge that The study had several limitations, such as the reliance on self-reporting of the NCGWS by participants, the contribution of some authors to a subset of studies included in the meta-analysis, and the inability to fully explain substantial differences in prevalence between included studies using regression analysis. They suggest that these differences in prevalence could reflect variability in diagnostic criteria and confounding factors, or could be real differences in prevalence between populations and countries.

However, the authors conclude: “Self-reported non-celiac gluten/wheat sensitivity affects approximately one in ten people worldwide, with considerable geographic variation and a strong association with female sex, psychological distress, and irritable bowel syndrome.”

They add that non-celiac gluten/wheat sensitivity should be recognized within the framework of the disorders of gut-brain interaction (a neurogastroenterology concept that emphasizes bidirectional communication between the gut and brain) and symptom-based diagnostic criteria should be developed “to guide a more personalized treatment approach focused on individual symptom patterns and dietary triggers beyond gluten and to reduce unnecessary dietary restriction in this common condition.”