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Reported symptoms of NCGS are similar to those of celiac disease, [30] [31] with most patients reporting both gastrointestinal and non-gastrointestinal symptoms. [29] [32] In the "classical" presentation of NCGS, gastrointestinal symptoms are similar to those of irritable bowel syndrome, and are also not distinguishable from those of wheat allergy, but there is a different interval between ...
Theoretically, a trial of gluten reintroduction to observe reaction after 1–2 years of strict gluten-free diet might be advisable. [37] Approximately one-third of persons with NCGS continue having symptoms despite gluten withdrawal. This may be due to diagnostic error, poor dietary compliance, or other reasons.
A recently proposed criterion to non-coeliac gluten sensitivity diagnosis concludes that an improvement of gastrointestinal symptoms and extra-intestinal manifestations higher than 50% with a gluten-free diet, assessed through a rating scale, may confirm the clinical diagnosis of non-coeliac gluten sensitivity. Nevertheless, this rating scale ...
Gluten-sensitive enteropathy–associated conditions are comorbidities or complications of gluten-related gastrointestinal distress (that is, gluten-sensitive enteropathy or GSE). GSE has key symptoms typically restricted to the bowel and associated tissues; however, there are a wide variety of associated conditions.
Refractory coeliac disease should not be confused with the persistence of symptoms despite gluten withdrawal [114] caused by transient conditions derived from the intestinal damage, [111] [112] [115] which generally revert or improve several months after starting a gluten-free diet, [116] [117] such as small intestinal bacterial overgrowth ...
[10] [21] Unlike EATL, it often occurs in celiac disease patients who, while otherwise well-maintained on a gluten-free diet, have vague gastrointestinal symptoms such as fatigue, malaise, and weight loss. [21] However, it can cause severe symptoms such as bowel obstruction [22] and intestinal bleeding. [23]
The diagnosis of underlying gluten sensitivity is complicated and delayed when there are no digestive symptoms. People who do experience gastrointestinal problems are more likely to receive a correct diagnosis and treatment. A strict gluten-free diet is the first-line treatment, which should be started as soon as possible. It is effective in ...
As antibody-negative coeliac disease is recognised, HLA status, persistence or progression of the duodenal IEL numbers following a gluten challenge, followed by symptomatic improvement on a gluten-free diet, has been used to be more certain about the diagnosis, which was made in 22% of one series of over 200 adult cases. [5]