Korean J Gastroenterol.  2020 Jan;75(1):11-16. 10.4166/kjg.2020.75.1.11.

Non-celiac Gluten Sensitivity

  • 1Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea. imdrkim@naver.com


Non-celiac gluten sensitivity (NCGS) is a term that is used to describe individuals who are not affected by celiac disease or wheat allergy, yet they have intestinal and/or extra-intestinal symptoms related to gluten ingestion with improvement of their symptoms upon withdrawing gluten from their diet. Gluten-related disorder groups are manifested by symptoms of gastrointestinal tract disorders, as well as hematological dermatological endocrinological, gynecological, rheumatological and nervous system symptoms. It is believed that NCGS represents heterogeneous groups with different subgroups characterized by different etiologies, clinical histories and clinical courses. There also appears to be an overlap between NCGS and irritable bowel syndrome (IBS). There is a need for establishing strict criteria for diagnosing NCGS. The absence of validated biomarkers remains a significant limitation for research studies on NCGS. New evidence shows that a gluten-free diet may be beneficial for some patients with gastrointestinal symptoms, such as those symptoms commonly found in patients with IBS. Further studies about NCGS are needed.


Nonceliac gluten sensitivity; Functional gastrointestinal disorders; Abdominal pain; Diarrhea; Glutens

MeSH Terms

Abdominal Pain
Celiac Disease
Diet, Gluten-Free
Gastrointestinal Diseases
Gastrointestinal Tract
Irritable Bowel Syndrome
Nervous System
Wheat Hypersensitivity


  • Fig. 1 Celiac disease and gluten-related disorders. WDEIA, wheat-dependent exercise-induced anaphylaxis.

  • Fig. 2 Salerno diagnosis algorithm of non-celiac gluten sensitivity. GFD, gluten free diet; A, product A (gluten or placebo); B, product B (placebo or gluten); E, evaluation (questionnaire); NCGS, non-celiac gluten sensitivity.

  • Fig. 3 Correlation of non-celiac gluten sensitivity and irritable bowel syndrome.


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