Gluten sensitivity linked to gut–brain interaction, not gluten itself, study finds

Gluten sensitivity, which affects around 10% of the world’s population, is not actually about gluten, but is part of the gut-brain interaction, research has revealed.

The results of this study are expected to set new benchmarks for how gluten sensitivity is defined, diagnosed and treated.

In the research review, published Today is lancetinvestigated the current published evidence on non-celiac gluten sensitivity (NCGS) to better understand this highly prevalent condition.

Although patients with NCGS experience symptoms after consuming gluten, they do not have celiac disease, an autoimmune disease caused by gluten. Common symptoms include bloating, intestinal pain, and fatigue.

Lead researcher Jessica Biesiekielski, an associate professor at the University of Melbourne, said the findings overturned a long-held hypothesis. gluten sensitivity.

“Contrary to popular belief, most patients with NCGS do not have a reaction to gluten,” Associate Professor Biesiekielski said.

“Our findings indicate that symptoms are often triggered by fermentable carbohydrates, commonly known as FODMAPs, other wheat ingredients, or people’s expectations or previous experience with the food.”

In the largest combined analyses, only a small number of tightly controlled trials found real gluten reactions. Overall, people’s responses were no different than when they were given a placebo.

“Recent research shows that IBS patients who believe they are gluten-sensitive react similarly to gluten, wheat and a placebo. This suggests that how people predict and interpret gut sensations can have a major impact on their symptoms,” Associate Professor Biesiekielski said.

“Taken together, this redefines NCGS as part of the gut-brain interaction spectrum, making it more akin to an irritable bowel syndrome-like condition rather than a distinct gluten disease.”

The research team from Australia, the Netherlands, Italy and the UK said the findings have major implications for people self-managing their gut symptoms, clinicians prescribing dietary restrictions and policy makers shaping public health messages.

“Millions of people around the world avoid gluten because they believe it has negative effects on their intestines, often after experiencing actual symptoms ranging from mild discomfort to severe distress. It is critical that we improve our scientific and clinical understanding of a disease that affects up to 15% of the world’s population,” said Associate Professor Biesiekielski.

Associate Professor Jason Tidin, director of the Snow Center for Immune Health and gastroenterologist at the Royal Melbourne Hospital, said the latest scientific knowledge could help clinicians provide more accurate diagnosis and personalized treatment for patients with NCGS.

“It is essential for clinicians to distinguish between NCGS and associated intestinal diseases in order to provide accurate diagnosis and personalized care and treat underlying contributing factors,” Professor Taidin said.

“This review supports a more individualized, evidence-based approach to gut health and avoids unnecessary dietary restrictions.”

Associate Professor Biesiekielski added that effective care for patients with NCGS requires a combination of dietary modification and psychological support, while ensuring nutritional adequacy.

“We want public health messaging to shift away from the following narrative: gluten “This study is inherently harmful because it shows that in many cases this is not the case,” she said.

“These discoveries also lead to better diagnostic tools, more rigorous clinical pathways, research funding Public education and improved food labeling are also important in this area. ”