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Brindicci VF, Franceschini S, Gnasso I, Alcini P, Tassi EA, Santarelli L, Cristofori F, Dargenio VN, Castellaneta S, Francavilla R. Self-Reported Nonceliac Gluten Sensitivity in Italian Young Adults: A Cross-Sectional Study. A Dietary Fad? Am J Gastroenterol 2024:00000434-990000000-01188. [PMID: 38874216 DOI: 10.14309/ajg.0000000000002885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/06/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION In different countries, the exact prevalence of people that refer symptoms after gluten ingestion is increasing and the unavailability of reliable laboratory tests to diagnose the condition known as nonceliac gluten sensitivity (NCGS) has opened the door to the spread of survey-based studies to hypothesize a prevalence of this condition with highly discordant results. We aim to describe the attitude toward gluten consumption in a large population of young adults in Italy. METHODS A questionnaire-based cross-sectional study was conducted in 13 Italian cities to investigate the dietary attitudes of more than 9,400 people distributed throughout the country about gluten consumption. Only those referring to gluten-related symptoms with a frequency equal to "always" or "most of the time" were considered self-reported NCGS (SR-NCGS) patients. RESULTS Five thousand two hundred thirty-four of 9,432 eligible participants (55.5%) fully completed the questionnaire. Excluding those with previous gastrointestinal diagnoses of celiac disease and wheat allergy, we have finally analyzed 4,987 questionnaires. Four hundred eighty-seven participants indicated gluten-related symptoms always or most of the time (SR-NCGS subjects), while 121 already had a medical diagnosis of NCGS. The minimum prevalence figure of SR-NCGS is 6.4% (95% confidence interval 6.0-6.9), with a higher prevalence in women (79.9%). The most frequent gluten-related symptoms were bloating, abdominal pain, and tiredness. DISCUSSION The high prevalence of people reporting symptoms after gluten ingestion requires that the diagnosis of NCGS should be ascertained with a double-blind controlled study to limit the number of people who improperly approach a gluten-free diet.
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Affiliation(s)
- Viviana Fara Brindicci
- Interdisciplinary Department of Medicine, Pediatric Section, Children's Hospital "Giovanni XXIII," University of Bari "Aldo Moro," Bari, Italy
| | - Simone Franceschini
- University of Chieti, Department of Medicine and Aging Sciences, Chieti, Italy
| | - Ilaria Gnasso
- Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Paride Alcini
- University of Chieti, Department of Medicine and Aging Sciences, Chieti, Italy
| | | | - Lorenzo Santarelli
- University of Chieti, Department of Medicine and Aging Sciences, Chieti, Italy
| | - Fernanda Cristofori
- Interdisciplinary Department of Medicine, Pediatric Section, Children's Hospital "Giovanni XXIII," University of Bari "Aldo Moro," Bari, Italy
| | - Vanessa Nadia Dargenio
- Interdisciplinary Department of Medicine, Pediatric Section, Children's Hospital "Giovanni XXIII," University of Bari "Aldo Moro," Bari, Italy
| | - Stefania Castellaneta
- Interdisciplinary Department of Medicine, Pediatric Section, Children's Hospital "Giovanni XXIII," University of Bari "Aldo Moro," Bari, Italy
| | - Ruggiero Francavilla
- Interdisciplinary Department of Medicine, Pediatric Section, Children's Hospital "Giovanni XXIII," University of Bari "Aldo Moro," Bari, Italy
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Verdelli A, Corrà A, Mariotti EB, Aimo C, Quintarelli L, Ruffo di Calabria V, Donati ME, Bonciolini V, Antiga E, Caproni M. Skin gluten-related disorders: new and old cutaneous manifestations to be considered. Front Med (Lausanne) 2023; 10:1155288. [PMID: 37265490 PMCID: PMC10229844 DOI: 10.3389/fmed.2023.1155288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/28/2023] [Indexed: 06/03/2023] Open
Abstract
The term gluten-related disorders (GRD) refer to a spectrum of different clinical manifestations triggered by the ingestion of gluten in genetically susceptible individuals, including coeliac disease (CD), wheat allergy and non-celiac gluten sensitivity (NCGS). GRD are characterized by a large variety of clinical presentations with both intestinal and extra-intestinal manifestations. The latter may affect almost every organ of the body, including the skin. Besides the well-known association between CD and dermatitis herpetiformis, considered as the cutaneous specific manifestation of CD, many other muco-cutaneous disorders have been associated to GRD. In this review, we analyzed the main features of dermatological diseases with a proven association with GRD and those that improve after a gluten-free diet, focusing on the newly described cutaneous manifestations associated with NCGS. Our main hypothesis is that a "cutaneous-gluten sensitivity," as specific cutaneous manifestation of NCGS, may exist and could represent a diagnostic marker of NCGS.
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Affiliation(s)
- Alice Verdelli
- Department of Health Sciences, Rare Dermatological Diseases Unit, Azienda USL Toscana Centro, European Reference Network-Skin Member, Florence, Italy
| | - Alberto Corrà
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Cristina Aimo
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Lavinia Quintarelli
- Department of Health Sciences, Rare Dermatological Diseases Unit, Azienda USL Toscana Centro, European Reference Network-Skin Member, Florence, Italy
| | | | - Marta Elettra Donati
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Emiliano Antiga
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Marzia Caproni
- Department of Health Sciences, Rare Dermatological Diseases Unit, Azienda USL Toscana Centro, European Reference Network-Skin Member, Florence, Italy
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Abstract
PURPOSE OF REVIEW To describe recent advances on nonceliac gluten sensitivity (NCGS), a recently described disorder characterized by variable symptoms and frequent irritable bowel syndrome (IBS)-like manifestations. RECENT FINDINGS The recent description of disease-triggering wheat components other than gluten, such as fructans and amylase-trypsin inhibitors (ATIs), definitely suggests that nonceliac wheat sensitivity (NCWS) is a better 'umbrella' terminology than NCGS. Self-reported NCWS is very common worldwide, particularly in patients seen at the gastroenterology clinic, but many of these diagnoses are not confirmed by standard clinical criteria. A biomarker of NCWS is still lacking, however, subtle histological features at the small intestinal biopsy may facilitate diagnosis. Treatment of NCWS is based on the gluten-free diet (GFD). The GFD has proven to be an effective treatment of a significant proportion of NCWS-related IBS patients. Dietary therapies for IBS, including the GFD, should be offered by dietitians who first assess dietary triggers and then tailor the intervention according to patient choice. Pioneer studies are under way to test the therapeutic efficacy of supplemental gluten-digesting enzyme preparations in patients with NCWS. SUMMARY Recent studies highlight interesting pathophysiological and clinical features of NCWS. Many questions remain, however, unanswered, such as the epidemiology, a biomarker(s), and the natural history of this clinical entity.
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Affiliation(s)
- Carlo Catassi
- Department of Odontostomatologic and Specialized Clinical Sciences, Polytechnic University of Marche, Ancona
| | - Giulia Catassi
- Pediatric Gastroenterology and Liver Unit, Department of Maternal and Child Health, Sapienza-University of Rome, Rome, Italy
| | - Loris Naspi
- Department of Psychology, Humboldt University, Berlin, Germany
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DE BASTIANI R, BARBETTI E, BERTOLUSSO L, CASELLA G, CAUCHI S, DE BASTIANI M, DE POLO M, FABBRICA D, FASULO S, LAZZAROTTO L, MARIANI G, NAPOLI L, ROSSI F, SANNA G, TOSETTI C, TURNAVA L, UBALDI E, VANNI E, ZAMPARELLA M, ELISEI W, TURSI A. Prevalence of celiac disease in family medicine setting: lower than expected and often with uncorrected diagnosis. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2023. [DOI: 10.23736/s0393-3660.22.04850-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Figueroa-Salcido OG, Arámburo-Gálvez JG, Ontiveros N. Estimating the Self-reported Prevalence of Non-celiac Gluten Sensitivity in the Korean Population. J Neurogastroenterol Motil 2022; 28:503. [PMID: 35799244 PMCID: PMC9274478 DOI: 10.5056/jnm22072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Oscar G Figueroa-Salcido
- Faculty of Nutrition Sciences, Nutrition Sciences Postgraduate Program, University of Sinaloa, Culiacán, Mexico
| | - Jesús G Arámburo-Gálvez
- Faculty of Nutrition Sciences, Nutrition Sciences Postgraduate Program, University of Sinaloa, Culiacán, Mexico
- Division of Biological and Health Sciences, Postgraduate Program in Health Sciences, University of Sonora, Hermosillo, Mexico
| | - Noé Ontiveros
- Division of Sciences and Engineering, Department of Chemical, Biological, and Agricultural Sciences (DC-QB), Clinical and Research Laboratory (LACIUS, URS), University of Sonora, Navojoa, Mexico
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Valentina G, Maria Z, Ruggiero F. Non-celiac Gluten Sensitivity or Celiac Disease, This Is Still the Question. J Neurogastroenterol Motil 2022; 28:504-505. [PMID: 35799245 PMCID: PMC9274471 DOI: 10.5056/jnm22075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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