Hôpital Européen Georges Pompidou, Service d’hépato-gastroentérologie et endoscopie digestive, 20 rue Leblanc 75015 Paris, France
Gluten related disorders include celiac disease, wheat allergy and non-celiac gluten sensitivity. Non celiac gluten sensitivity is characterized by intestinal and extra-intestinal symptoms that occur after gluten ingestion, disappear with gluten withdrawal from diet and relapse following gluten challenge. These manifestations are similar to those occuring in celiac disease and irritable bowel syndrom. However, patients with non-celiac gluten sensitivity do not suffer from lesions in the duodenal mucosa and do not develop tissue transglutaminase or endomysium antibodies. The pathogenesis is not yet well understood and the role of gluten is still controversial, with studies suggesting that FODMAPs or other wheat proteins could be responsible for the symptoms. The diagnosis is made after exclusion of celiac disease and wheat allergy. There are no laboratory markers specific to gluten sensitivity. Treatment consists in avoiding gluten to improve symptoms.
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