期刊
BEST PRACTICE & RESEARCH CLINICAL GASTROENTEROLOGY
卷 29, 期 3, 页码 477-491出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.bpg.2015.04.006
关键词
Celiac disease; Duodenal biopsy; Anti-gliadin antibodies; Innate/adaptive immunity; Irritable bowel syndrome; Wheat allergy
Non-celiac gluten sensitivity is an undefined syndrome with gastrointestinal and extra-intestinal manifestations triggered by gluten in patients without celiac disease and wheat allergy. The pathogenesis involves immune-mediated mechanisms requiring further research. Symptoms disappear in a few hours or days after gluten withdrawal and recur rapidly after gluten ingestion. Besides gluten, other wheat proteins as well as fermentable oligo-, di-, mono-saccharides and polyols (FODMAPs) may contribute to this syndrome. This syndrome occurs mainly in young women, being rare in children. Its prevalence ranges from 0.6% to 6%, based on primary or tertiary care center estimates. No biomarker is available, but half of patients tests positive for IgG anti-gliadin antibodies, which disappear quickly after gluten-free diet together with symptoms. Also, genetic markers are still undefined. Although currently limited to a research setting, double-blind, placebo-controlled, cross-over trial strategy is recommended to confirm the diagnosis. Treatment is based on dietary restriction with special care to nutrient intake. (C) 2015 Elsevier Ltd. All rights reserved.
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