Review Non-celiac Gluten Sensitivity: A New Clinical Entity or Growing Controversy? 2026 Bektaş

[Andy]

Aims and background: Non-celiac gluten sensitivity (NCGS) has become an increasingly recognized condition, yet its diagnostic framework remains vague. Unlike celiac disease, NCGS lacks specific biomarkers and relies heavily on self-reported symptoms. Despite this ambiguity, the gluten-free product market reached USD 20.1 billion in 2021 and is projected to exceed USD 26.5 billion by 2030, indicating widespread adoption beyond medically justified use.

Results: Emerging evidence suggests that gluten may not be the sole trigger in NCGS. Other wheat components, including amylase-trypsin inhibitors (ATIs), wheat germ agglutinin (WGA), and fructans, may contribute to symptom generation. Accordingly, the term “non-celiac wheat sensitivity (NCWS)” is increasingly preferred. Studies also show that low-FODMAP diets can alleviate symptoms attributed to NCGS, complicating the diagnostic distinction from irritable bowel syndrome (IBS) and other disorders of gut–brain interaction (DGBIs). The presence of antigliadin antibodies (AGA) or HLA-DQ2/DQ8 haplotypes may suggest predisposition, but these are neither specific nor diagnostic for NCGS.

Conclusion: The lack of standardized diagnostic criteria and the influence of the nocebo effect pose significant challenges in the clinical assessment of NCGS. Self-reported outcomes alone are insufficient for a reliable diagnosis.

Clinical significance: The unwarranted adoption of gluten-free diets in individuals without confirmed gluten-related disorders may lead to nutritional imbalance and disruption of the gut microbiota. Until validated diagnostic tools are established, clinicians should evaluate suspected NCGS cautiously, considering differential diagnoses and evidence-based dietary guidance.

Open access

 

[Midnattsol]

Evidence based with what evidence base? Calling it wheat sensitivity or gluten intolerance would still require more or less the same dietary changes.

 

[Peter T]

My non-celiac gluten intolerance is also triggered by rye, so replacing the word gluten with wheat would not be accurate for me.

I have no idea if my food intolerances reflect a discrete clinic entity or are symptoms of my ME/CFS. Certainly in ME/CFS we need much better data.

 

[MeSci]

My non-celiac gluten intolerance is also triggered by rye, so replacing the word gluten with wheat would not be accurate for me.

I have no idea if my food intolerances reflect a discrete clinic entity or are symptoms of my ME/CFS. Certainly in ME/CFS we need much better data.

Yes - I have non-coeliac gluten intolerance too, and I suspect that it includes rye, but I no longer risk trying rye. I use gluten-free bread and rolls.

I am also intolerant of buckwheat, which is added to some gluten-free (and gluten-containing?) products, goodness knows why. I've tried it a few times, and it always messes my gut up, which is pretty well-behaved otherwise now that I've cut out the offending ingredients.

 

[alex3619]

I cannot say I have gluten intolerance. What I have is severe sudden bronchospasms after eating hard wheat, the kind used in pasta. The harder the wheat, the more the gluten, the worse I react. However I can eat small amounts of regular wheat, and large of sourdough. Yet one tiny portion of pasta can potentially kill me. No diagnosis, baffling the specialists, what can I do about it but avoid pasta, one of my favorite foods?

 

[Jonathan Edwards]

The unwarranted adoption of gluten-free diets in individuals without confirmed gluten-related disorders may lead to nutritional imbalance and disruption of the gut microbiota.

This seems to me just meddlesome. At various times during my life I have had to give up plums, prawns, aubergines and Jerusalem artichokes, although I can now tolerate most of them, even if I get night pain after aubergines still. I don't think I was at risk of nutritional imbalance or 'disruption of the gut microbiota' whatever that might be. I don't see any particular need to eat wheat or rye, although it may be inconvenient not to be able to.

 

[Midnattsol]

My non-celiac gluten intolerance is also triggered by rye, so replacing the word gluten with wheat would not be accurate for me.

I have no idea if my food intolerances reflect a discrete clinic entity or are symptoms of my ME/CFS. Certainly in ME/CFS we need much better data.

It's silly for a number of reasons to focus on wheat as many of the potential problematic compounds are also found in other grains, not even just gluten-containing grains. But anything to not fall for a fad such as gluten-free I guess.

This seems to me just meddlesome. At various times during my life I have had to give up plums, prawns, aubergines and Jerusalem artichokes, although I can now tolerate most of them, even if I get night pain after aubergines still. I don't think I was at risk of nutritional imbalance or 'disruption of the gut microbiota' whatever that might be. I don't see any particular need to eat wheat or rye, although it may be inconvenient not to be able to.

Plums, prawns, aubergines and jerusalem artichokes are not stapes in the general population's diet and not assumed to provide as many nutrients day-to-day. On the other hand you as an individual could depend on those foods for some nutrient or other and thus such group-level statistics are not necessarily helpful.

 

[rvallee]

The unwarranted adoption of gluten-free diets in individuals without confirmed gluten-related disorders may lead to nutritional imbalance and disruption of the gut microbiota

Now who's catastrophizing? LMAO. Humans don't need to eat wheat, people are simply trying to figure out things on their own and this is what it looks like because medicine keeps coming with the same bullshit instead of actually trying to work things out.

the influence of the nocebo effect

More gullibo. The entire wellness coaching/rehabilitation industry is built around trying to exploit made-up bullshit so this whining is completely hollow. It's extremely frustrating trying to figure out what causes problems when the effects are so damn unpredictable and all without any meaningful information or support.

 

[Creekside]

I'm presently still intolerant of wheat, but I think I'm tolerant of buckwheat (I was expecting to show symptoms this morning, but haven't yet), while a few weeks ago I was intolerant of buckwheat too. So yes, there are other components of wheat and other grains and seeds that can cause trouble for people. The health scam industry has convinced the majority of people that wheat=gluten.

Dropping wheat from one's diet does not risk severe consequences. That seems like a build-up for another marketing push.

 

[Snoopydog1]

My non-celiac gluten intolerance is also triggered by rye, so replacing the word gluten with wheat would not be accurate for me.

I have no idea if my food intolerances reflect a discrete clinic entity or are symptoms of my ME/CFS. Certainly in ME/CFS we need much better data.

I am the same. Looking back when I was a young teenager I used to add wheat germ called Bemax to a cereal like corn flakes and every time I did this the back of my throat and uvula would go bright red and would irritate intensely. I remember gargling to try and make it go away.

So I think I was intolerant of wheat probably all my life. I developed bad gut issues during my 20s but in those days it wasn’t spoken about. I was in my 40s when my health had badly deteriorated when I first learned about it and have been gluten free for over 26 years now and rarely get the huge bloating that was a daily occurrence making me look highly pregnant.