Gluten/wheat sensitivity
How common is non-coeliac gluten/wheat sensitivity?
The prevalence of gluten/wheat sensitivity (non-coeliac gluten sensitivity, NCGS, or non-coeliac wheat sensitivity, NCWS) is unclear due to the lack of a specific biomarker. Available estimates vary widely, ranging from 0.49% to 14.9% of the general population. This significantly exceeds the assumed prevalence of other grain- and gluten-associated disorders (GRD).
Wheat sensitivity: unclear frequency without biomarkers
The prevalence of gluten/wheat sensitivity remains unknown in many regions around the world. This is mainly due to the fact that there are currently no sensitive and reproducible biomarkers available for diagnosis. There is also no standardised diagnostic procedure that can be used in clinical practice. Epidemiological studies on gluten/wheat sensitivity are therefore mostly based on surveys conducted either in person or via online platforms.
Such surveys usually define self-reported cases of gluten/wheat sensitivity based on the following criteria:
- Self-reported symptoms after consuming gluten or wheat
- No medically diagnosed coeliac disease or wheat allergy
- Adherence to a gluten-free diet
The resulting prevalence estimates range from 0.49% to 14.9%.
However, these figures should be interpreted with caution, as they are not supported by objective diagnostic tests (e.g. HLA typing, serology, oral provocation). The wide range of results can be explained, among other things, by differences in the questionnaires used, the target groups and the survey methods.
Gluten sensitivity – often without a medical diagnosis
One study reports that up to 13% of the population claim to have self-diagnosed gluten sensitivity. This highlights a widespread pattern: many affected individuals diagnose themselves, often without medical clarification, and start a gluten-free diet on their own.
This form of self-reported gluten/wheat sensitivity is widespread worldwide and occurs particularly frequently in patients in gastroenterology practices. In an Italian study, 20% of outpatients undergoing endoscopy reported self-diagnosed gluten/wheat sensitivity, with younger women being particularly affected. In India, 11.3% of patients with irritable bowel syndrome(IBS) reported gluten/wheat sensitivity, while none of the healthy control subjects were affected.
However, the actual relevance of this self-reported sensitivity remains unclear. Only a small proportion of those affected meet the criteria for gluten/wheat sensitivity upon closer clinical examination.
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