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Ideas and Opinions |

Nonceliac Gluten Sensitivity: Sense or Sensibility?

Antonio Di Sabatino, MD; and Gino Roberto Corazza, MD
[+] Article, Author, and Disclosure Information

Potential Conflicts of Interest: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-1932.

Requests for Single Reprints: Gino Roberto Corazza, MD, Clinica Medica I, Fondazione IRCCS Policlinico San Matteo, Università di Pavia, Piazzale Golgi 5, 27100 Pavia, Italy; e-mail, mailto:gr.corazza@smatteo.pv.it.

Current Author Addresses: Drs. Di Sabatino and Corazza: Clinica Medica I, Fondazione IRCCS Policlinico San Matteo, Università di Pavia, Piazzale Golgi 5, 27100 Pavia, Italy.

Author Contributions: Conception and design: A. Di Sabatino, G.R. Corazza.

Drafting of the article: A. Di Sabatino, G.R. Corazza.

Critical revision of the article for important intellectual content: A. Di Sabatino, G.R. Corazza.

Final approval of the article: A. Di Sabatino, G.R. Corazza.

From Centro per lo Studio e la Curia della Mallatia Celiaca, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.

Ann Intern Med. 2012;156(4):309-311. doi:10.7326/0003-4819-156-4-201202210-00010
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Recent studies support the existence of a new condition, nonceliac gluten sensitivity, which manifests as intestinal or extraintestinal symptoms that improve or disappear after gluten withdrawal in individuals with normal small-bowel mucosa and negative results on serum antitransglutaminase and antiendomysial antibody testing. Although the clinical value of this concept is under debate, the prevalence of nonceliac gluten sensitivity in the general population is supposed to be many times higher than that of celiac disease. The lack of an unambiguous definition of nonceliac gluten sensitivity, a major pitfall, is primarily related to the heterogeneous cause of this condition, whose symptoms are presumed to be caused by different mechanisms. If nonceliac gluten sensitivity is an etiologically heterogeneous syndrome, then management options should vary according to the predominant or concomitant underlying pathogenic pathways.





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