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One in ten people consider themselves gluten-sensitive without a diagnosis

Non-celiac gluten/wheat sensitivity is often self-diagnosed, leading millions of people without celiac disease to follow gluten-free diets. Discover the key facts.

Around 10% of the world's population claims to suffer from gluten or wheat sensitivity without a clinical diagnosis

Around the world, more and more people are following a gluten-free diet without having been diagnosed with celiac disease. Many of them experience gastrointestinal and extraintestinal symptoms after consuming gluten-containing foods and find relief by eliminating them from their diet. This change is often based on a self-diagnosis of non-celiac gluten or wheat sensitivity (NCGWS). Its pathophysiology is not yet clearly defined: there are no specific biomarkers, and differentiating it from functional disorders such as irritable bowel syndrome remains a challenge.

The diagnosis is therefore based on ruling out celiac disease and wheat allergy, along with a subjective improvement in symptoms on a gluten-free diet. In this context, it is increasingly important to understand NCGWS from a scientific standpoint.

A recent meta-analysis comprehensively analyzed the prevalence of self-reported NCGWS, its clinical characteristics, and associated factors. Its objective was to shed light on this complex clinical picture, question the usual therapeutic approach, and explore possible links with stress, mental health, and the gut-brain axis.

The complexity of non-celiac gluten sensitivity

Unlike celiac disease, an autoimmune disease with measurable biomarkers, non-celiac gluten/wheat sensitivity lacks a defined cause and specific diagnostic tests. Its diagnosis is only established by ruling out celiac disease and wheat allergy in people who report symptoms after consuming gluten.

The meta-analysis "Global prevalence of self-reported non-celiac gluten and wheat sensitivity" reveals that about 10% of the world's population claims to suffer from NCGWS, and analyzes its causes, prevalence, and challenges for clinical practice.

Study methodology

The study by Shiha et al. reviewed 25 studies published between 2014 and 2024, with data from approximately 50,000 people in 16 countries in the Americas, Europe, the Eastern Mediterranean, Southeast Asia, and the Western Pacific.

The research assessed:

self-reported gluten or wheat sensitivity
symptoms present
sociodemographic factors
associations with psychological disorders
relationship with functional digestive diseases

The studies included were population surveys with heterogeneous methodologies.

Main results

10% of respondents reported NCGWS.
Of these, 40% followed a gluten-free diet.
High-income countries demonstrated a higher prevalence than middle- or low-income countries.
Twice as many cases were reported in women than in men.
There were significant associations with anxiety, depression, and irritable bowel syndrome.

Most common symptoms

Gastrointestinal:

Bloating
General discomfort
Nausea
Abdominal pain
Diarrhea
Constipation

Extraintestinal:

Fatigue
Headaches
Skin rashes
Joint pain

Conclusion

The data show that self-diagnosed gluten/wheat sensitivity is common, but it does not correspond to a homogeneous clinical picture or a clear pathophysiology. Its strong association with females, psychological disorders, and irritable bowel syndrome, as well as its marked geographical variability, suggests that factors such as the gut-brain axis may play a key role.

Gluten may not be the primary culprit in all cases; other components such as FODMAPs could explain the symptoms in certain patients.

The authors propose a revision of the concept of NCGWS toward an approach focused on gut-brain axis disorders and standardized diagnostic criteria. For clinical practice, it is recommended that a gluten-free diet not be adopted without an accurate diagnosis and always under professional supervision.

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