One in ten non-coeliac people experience various symptoms after eating gluten

Non-coeliac gluten and wheat sensitivity (NCGWS) is a self-diagnosed condition characterised by both gastrointestinal and extraintestinal symptoms after ingesting gluten or wheat in people who do not have coeliac disease or wheat allergy. It has emerged as a global phenomenon in recent years; however, there are no estimates of its prevalence, clinical characteristics, or factors associated with this condition.

The systematic review and meta-analysis by MG Shiha and co-authors has a robust design. It analyses 25 studies published in 2014-2024 involving 49,000 individuals (mostly adults) from 16 countries in various geographical regions (the Americas, Europe, the Western Pacific, Southeast Asia and the Eastern Mediterranean). Only two of the 25 studies included paediatric data.

The meta-analysis concludes that the overall prevalence of self-reported NCGWS is 10.3%, but indicates considerable variability between the studies analysed. This condition is mainly associated with female gender and comorbidities such as irritable bowel syndrome, anxiety or depression. The authors suggest that the gut-brain axis may be responsible for this condition and point to the need for studies exploring immunological mechanisms, the state of the intestinal barrier and the microbiota, in order to rule out other clinical diagnoses, since 40% of the population avoids gluten consumption, mostly without medical advice or diagnosis.

Despite the disparity in prevalence between regions, as this is a self-diagnosed condition, the study is rigorous and comprehensive and represents a starting point for improving the clinical management of NCGWS.