Biesiekierski Jessica R, Newnham Evan D, Shepherd Susan J, Muir Jane G, Gibson Peter R
Department of Gastroenterology, Eastern Health Clinical School, Monash University, Victoria, Australia Department of Gastroenterology, Central Clinical School, Monash University, The Alfred Hospital, Melbourne, Victoria, Australia
Department of Gastroenterology, Eastern Health Clinical School, Monash University, Victoria, Australia.
Nutr Clin Pract. 2014 Aug;29(4):504-509. doi: 10.1177/0884533614529163. Epub 2014 Apr 16.
Background: Nonceliac gluten sensitivity (NCGS), occurring in patients without celiac disease yet whose gastrointestinal symptoms improve on a gluten-free diet (GFD), is largely a self-reported diagnosis and would appear to be very common. The aims of this study were to characterize patients who believe they have NCGS. Materials and Methods: Advertising was directed toward adults who believed they had NCGS and were willing to participate in a clinical trial. Respondents were asked to complete a questionnaire about symptoms, diet, and celiac investigation. Results: Of 248 respondents, 147 completed the survey. Mean age was 43.5 years, and 130 were women. Seventy-two percent did not meet the description of NCGS due to inadequate exclusion of celiac disease (62%), uncontrolled symptoms despite gluten restriction (24%), and not following a GFD (27%), alone or in combination. The GFD was self-initiated in 44% of respondents; in other respondents it was prescribed by alternative health professionals (21%), dietitians (19%), and general practitioners (16%). No celiac investigations had been performed in 15% of respondents. Of 75 respondents who had duodenal biopsies, 29% had no or inadequate gluten intake at the time of endoscopy. Inadequate celiac investigation was common if the GFD was initiated by self (69%), alternative health professionals (70%), general practitioners (46%), or dietitians (43%). In 40 respondents who fulfilled the criteria for NCGS, their knowledge of and adherence to the GFD were excellent, and 65% identified other food intolerances. Conclusions: Just over 1 in 4 respondents self-reporting as NCGS fulfill criteria for its diagnosis. Initiation of a GFD without adequate exclusion of celiac disease is common. In 1 of 4 respondents, symptoms are poorly controlled despite gluten avoidance.
非乳糜泻麸质敏感（NCGS）发生于无乳糜泻但胃肠道症状在无麸质饮食（GFD）时改善的患者中，很大程度上是一种自我报告的诊断，且似乎非常常见。本研究的目的是描述那些认为自己患有NCGS的患者特征。材料与方法：针对认为自己患有NCGS且愿意参加临床试验的成年人进行广告宣传。受访者被要求完成一份关于症状、饮食和乳糜泻检查的问卷。结果：在248名受访者中，147人完成了调查。平均年龄为43.5岁，130人为女性。72%的人不符合NCGS的描述，原因包括乳糜泻排除不充分（62%）、尽管限制麸质摄入但症状未得到控制（24%）以及未遵循GFD（27%），单独或多种情况并存。44%的受访者自行开始采用GFD；在其他受访者中，GFD由替代健康专业人员（21%）、营养师（19%）和全科医生（16%）开具。15%的受访者未进行过乳糜泻检查。在75名进行十二指肠活检的受访者中，29%在内镜检查时麸质摄入不足或摄入不充分。如果由患者自行（69%）、替代健康专业人员（70%）、全科医生（46%）或营养师（43%）开始采用GFD，乳糜泻检查不充分很常见。在40名符合NCGS标准的受访者中，他们对GFD的了解和依从性很好，65%的人还发现了其他食物不耐受情况。结论：自称患有NCGS的受访者中，略多于四分之一符合其诊断标准。在未充分排除乳糜泻的情况下开始采用GFD很常见。四分之一的受访者中，尽管避免了麸质摄入，但症状控制不佳。
