Non-celiac gluten/wheat sensitivity (NCGS)
How common is gluten/wheat sensitivity?
The prevalence of gluten/wheat sensitivity (non-celiac gluten sensitivity, NCGS, or non-celiac wheat sensitivity, NCWS) remains uncertain due to the absence of specific biomarkers. Estimates vary widely, ranging from 0.49% to 14.9% of the general population—significantly higher than the estimated prevalence of other gluten- and grain-related disorders (GRDs).
Wheat sensitivity: unclear frequency without biomarkers
The global prevalence of gluten/wheat sensitivity remains largely unknown, primarily due to the lack of sensitive and reproducible biomarkers for diagnosis. Additionally, there is no standardized diagnostic protocol suitable for routine clinical use. As a result, most epidemiological data are derived from self-reported surveys conducted in person or online.
These surveys typically define self-reported gluten/wheat sensitivity based on the following criteria:
- Self-reported symptoms after consuming gluten or wheat
- No medically diagnosed celiac 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 cautiously, as they are not supported by objective diagnostic methods such as HLA typing, serological testing, or oral food challenges. The wide variability in prevalence estimates may be attributed to differences in survey instruments, target populations, and data collection methodologies.
Gluten sensitivity – often without a medical diagnosis
One study found that up to 13% of individuals self-identify as having gluten sensitivity, often without undergoing medical evaluation. This highlights a common trend: many individuals initiate a gluten-free diet based on self-diagnosis rather than clinical confirmation.
Self-reported gluten/wheat sensitivity is widespread globally and is particularly common among patients seen in gastroenterology clinics. For example, an Italian study reported that 20% of outpatient endoscopy patients claimed to have gluten/wheat sensitivity, with a higher prevalence among younger women. In India, 11.3% of patients with irritable bowel syndrome (IBS) reported gluten/wheat sensitivity, whereas none of the healthy controls did.
Nonetheless, the clinical relevance of self-reported gluten/wheat sensitivity remains uncertain. Only a small subset of individuals who report symptoms meet the diagnostic criteria for gluten/wheat sensitivity upon thorough clinical evaluation.
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