Patients with Suspected NCGS Not Able to Identify When Challenged with Gluten

1. Twenty patients (14F/6M, age range: 21-62 years) with suspected NCGS, without coeliac disease and wheat-allergy, were included while on a gluten-free diet.
2. All patients went through four periods of double-blinded provocation, two with gluten and two with placebo in randomized order.
3. They consumed two muffins a day (11/0 g gluten) for 4 days, followed by a 3-day wash-out.
4. Gastrointestinal symptoms were recorded with questionnaires at baseline and after each provocation.
5. We also investigated whether patients were able to correctly identify periods with gluten-exposure.

KEY RESULTS:

1. Collectively the whole group reported the most severe symptoms after placebo (P = .012).
2. Four out of twenty patients correctly identified the two periods when they received gluten, hence were diagnosed with NCGS.
3. The diagnosed-group tended to show higher symptom scores than the not-diagnosed group both at baseline, after gluten exposure and after placebo, but no clear difference was seen between provocation with gluten and placebo.
4. The not-diagnosed group showed more severe symptoms with placebo than with gluten (P = .029).

CONCLUSIONS AND INFERENCES:

• The present study showed that the majority of patients with suspected NCGS are not able to identify when challenged with gluten in a double-blind placebo-controlled food challenge, indicating that gluten is not the cause of their symptoms.

• ¹ John Wiley & Sons Ltd, Neurogastroenterology & Motility

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SOURCE ARTICLE 

The effect of a controlled gluten challenge in a group of patients with suspected non‐coeliac gluten sensitivity: A randomized, double‐blind placebo‐controlled challenge