Priyanka P, Gayam S, Kupec J T
Department of Medicine, West Virginia University Hospitals, Morgantown, WV, USA.
Department of Medicine, Section of Digestive Diseases, West Virginia University Hospitals, Morgantown, WV, USA.
Gastroenterol Res Pract. 2018 Aug 6;2018:1561476. doi: 10.1155/2018/1561476. eCollection 2018.
Nonceliac gluten sensitivity (NCGS) is a recently defined clinical entity characterized by intestinal and extraintestinal symptoms associated with gluten ingestion in individuals in whom celiac disease (CD) or wheat allergy (WA) has been excluded. Despite its name and definition, gluten has been shown to precipitate symptoms in only 16-30% of these patients. In addition to gluten, other components of wheat, including fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs), alpha-amylase trypsin inhibitors (ATIs) and wheat germ agglutinin have been implicated in the causation of the symptoms of NCGS, with FODMAPs garnering the most attention. We present a review of the existing literature evaluating the role of FODMAPs in NCGS symptomatology.
A systematic review of PubMed, Cochrane, EMBASE, and Google Scholar for keywords fructans, non-celiac gluten sensitivity, NCGS, FODMAPs, and gluten-free diet (GFD) was conducted through a series of advanced searches. Articles related to the use of fructans or FODMAPs were analyzed.
FODMAPs were found to be associated with gastrointestinal and extraintestinal symptoms in NCGS.
A low FODMAP diet has potential for improvement of clinical symptoms in NCGS. In addition, some evidence suggests an additional benefit to simultaneous adherence to both low FODMAP diet and GFD.
非乳糜泻麸质敏感（NCGS）是一种最近定义的临床实体，其特征为在已排除乳糜泻（CD）或小麦过敏（WA）的个体中，摄入麸质后出现肠道和肠道外症状。尽管有其名称和定义，但麸质仅在16% - 30%的此类患者中引发症状。除麸质外，小麦的其他成分，包括可发酵的低聚糖、双糖、单糖和多元醇（FODMAPs）、α -淀粉酶胰蛋白酶抑制剂（ATIs）和麦胚凝集素，都与NCGS症状的产生有关，其中FODMAPs受到的关注最多。我们对现有文献进行综述，评估FODMAPs在NCGS症状学中的作用。
通过一系列高级搜索，对PubMed、Cochrane、EMBASE和谷歌学术进行系统综述，搜索关键词为果聚糖、非乳糜泻麸质敏感、NCGS、FODMAPs和无麸质饮食（GFD）。分析与果聚糖或FODMAPs使用相关的文章。
发现FODMAPs与NCGS的胃肠道和肠道外症状有关。
低FODMAP饮食有可能改善NCGS的临床症状。此外，一些证据表明同时坚持低FODMAP饮食和GFD有额外益处。
