Reports suggest that gluten sensitivity exists in the absence of celiac disease.
This clinical entity has been termed nonceliac gluten sensitivity.
Dr Aziz and colleagues from the United Kingdom determined the population prevalence of self-reported gluten sensitivity and referral characteristics to secondary care.
A UK population-based questionnaire screened for gluten sensitivity and related symptoms.
Diagnostic outcomes were also analyzed in patients referred to secondary care with gluten sensitivity.
|The prevalence for gluten sensitivity was 13%|
|European Journal of Gastroenterology & Hepatology|
Celiac disease diagnosis entailed a positive celiac serology plus Marsh 1-3 on duodenal biopsies.
Nonceliac gluten sensitivity diagnosis was based on exclusion of celiac disease.
Clinical comparisons were made between nonceliac gluten sensitivity and celiac disease.
A total of 1002 adults in the population.
The self-reported prevalence for gluten sensitivity was 13%, with 4% consuming a gluten-free diet and 0.8% known to have a doctor diagnosis of celiac disease.
The team found that individuals with gluten sensitivity had an increased prevalence of fulfilling the Rome III criteria for irritable bowel syndrome, in comparison with those without gluten sensitivity.
In secondary care 200 gluten sensitivity patients were investigated, in whom 7% were found to have celiac disease, and 93% to have nonceliac gluten sensitivity.
The researchers observed that all celiac disease patients were human leucocyte antigen DQ2 or DQ8 positive compared with 53% of nonceliac gluten sensitivity cases.
Nutritional deficiencies, autoimmune disorders and a lower mean BMI were significantly associated with celiac disease compared with nonceliac gluten sensitivity.
Dr Aziz's team comments, "Gluten sensitivity is commonly self-reported with symptoms suggesting an association with irritable bowel syndrome."
"The majority of patients have nonceliac gluten sensitivity, an entity which demonstrates clinical and immunologic difference to celiac disease."