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Most Who Avoid Gluten Lack Symptoms of Intolerance, Sensitivity

Issue: July 2018

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WASHINGTON — Most individuals on a gluten-free diet do not avoid gluten because of specific gluten-related symptoms, according to data presented at Digestive Disease Week.

Barbara Zanini, MD, of the University of Brescia in Italy, and colleagues found that less than one-third of patients without celiac disease currently on a gluten-free diet had a self-reported wheat intolerance (SRWI). Even fewer had a diagnosis of non-celiac gluten sensitivity (NCGS). Zanini presented these findings based on the results from an epidemiologic and clinical study of the prevalence of NCGS and SRWI in a community in northern Italy.

“The avoidance of gluten or wheat products, without medical advice, is an increasing worldwide phenomenon, not supported by good medical evidence,” Zanini said in a presentation.

The investigators recruited patients for the epidemiologic stage of the study by mailing a questionnaire to the adult population of Monticelli Brusati, a town in northern Italy. The survey included a modified version of the gastrointestinal symptom rating scale to identify individuals with SRWI. In the clinical phase, the researchers sought to confirm or rule out a diagnosis of NCGS in those patients.

Of the 739 people that returned the questionnaire, 39 reported that they were on a gluten-free diet (5.3%). Researchers identified from this group 12 people with SRWI (31%) and 27 people that avoided gluten despite the absence of an association between gluten ingestion and clinical manifestations (69%).

In 10 patients that completed the clinical phase of the study, Zanini and colleagues determined that four had NCGS, suggesting a prevalence in the overall population 0.5%.

“People adhering to a gluten free diet are a mixed population,” Zanini said. “Less than one-third of them avoid gluten because of symptoms.” – by Alex Young

Reference:

Zanini B, et al. Abstract 580. Presented at: Digestive Disease Week; June 2-5, 2018; Washington, D.C.

Disclosures: Zanini reports no relevant financial disclosures. Please see the DDW faculty disclosure index for a list of all other authors’ relevant financial disclosures.