Molina-Infante Javier, Santolaria Santos, Montoro Miguel, Esteve María, Fernández-Bañares Fernando
Servicios de Aparato Digestivo, Hospital San Pedro de Alcántara, Cáceres, España.
Servicio de Aparato Digestivo, Hospital San Jorge, Huesca, España.
Gastroenterol Hepatol. 2014 Jun-Jul;37(6):362-71. doi: 10.1016/j.gastrohep.2014.01.005. Epub 2014 Mar 22.
Non-celiac gluten sensitivity (NCGS) is an emerging disorder characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food in non-celiac patients. Its prevalence has been estimated to be six to ten-times higher than that of celiac disease (CD). A gluten-free diet is the most widely recommended therapy, but the causative agent remains unknown and there are no consensus diagnostic criteria. Recent studies on NCGS have included patients with possibly overlooked minor CD and diarrhea-predominant irritable bowel syndrome without self-reported gluten intolerance, but showing a response to a gluten-free diet. Furthermore, FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) have recently been postulated as the culprit component for NCGS in wheat, instead of gluten. This review updates evidence on the pathophysiology of NCGS and the efficacy of different dietary interventions in its treatment, stressing the need for proper screening for CD before a diagnosis of NCGS is made.
非乳糜泻麸质敏感(NCGS)是一种新出现的疾病,其特征是在非乳糜泻患者中出现与摄入含麸质食物相关的肠道和肠道外症状。据估计,其患病率比乳糜泻(CD)高6至10倍。无麸质饮食是最广泛推荐的治疗方法,但病因仍不明,且尚无共识性诊断标准。最近关于NCGS的研究纳入了可能被忽视的轻度CD患者以及腹泻型肠易激综合征患者,这些患者虽未自述麸质不耐受,但对无麸质饮食有反应。此外,最近有人提出,可发酵寡糖、双糖、单糖和多元醇(FODMAPs)而非麸质是小麦中导致NCGS的罪魁祸首成分。本综述更新了关于NCGS病理生理学及不同饮食干预治疗效果的证据,强调在诊断NCGS之前需要对CD进行适当筛查。