Non-coeliac gluten sensitivity (NCGS) occurs with very non-specific symptoms that resemble those of coeliac disease or wheat allergy and can have both intestinal and extraintestinal manifestations. There is also overlap between the symptoms of NCGS and irritable bowel syndrome.
As with coeliac disease, the symptoms of NCGS are very diverse and the clinical picture is very broad. This means that it is not possible to distinguish between different gluten-related complaints on the basis of symptoms alone. Symptoms related to NCGS can vary from typical gastrointestinal complaints including diarrhoea, abdominal pain and bloating to extra intestinal manifestations including fatigue, headaches and joint pain. Some patients may be able to tolerate a small amount of gluten without developing clinical symptoms. In contrast to coeliac disease patients, strict gluten avoidance may not therefore be necessary. The list below illustrates the intestinal and extraintestinal symptoms that can manifest in NCGS patients.
Common symptoms of NCGS
|Gastrointestinal complaints||Gastrointestinal complaints|
|Bloating||Lack of well-being|
|Diarrhoea or constipation||Headaches|
|Upper abdominal pain||Anxiety|
|Nausea||Mental confusion ("foggy mind")|
|Gastro-oesophageal reflux||Numbness in arms and legs|
|Aphthous stomatitis||Fibromyalgia-like joint and muscle pain|
|Heartburn or vomiting||Dermatitis/rashes|
Catassi et al. Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salernos Experts' Criteria. Nutrients 2015, 7(6), 4966-4977