Non-Celiac Disease-Non-Wheat Allergy-Wheat Sensitivity
The non-celiac gluten sensitivity (Syn .: wheat sensitivity , English non-celiac gluten sensitivity is NCGS, abbreviated) a wheat intolerance with one of celiac disease (inflammatory response of the intestinal mucosa to the "gluten" gluten ) clinically similar image despite exclusion an autoimmune reaction ( endomysium antibodies, tissue-specific transglutaminase antibodies) or a wheat allergy ( prick test , specific IgE ).
The cause is assumed to be innate immunity to alpha-amylase trypsin inhibitors (ATI). Approx. 20% of people may also be intolerant to the otherwise harmless fermentable oligo-, di-, monosaccharides and polyols (FODMAP) from legumes and some types of fruit, vegetables and cereals - including wheat.
There is currently no laboratory test procedure. Irritable bowel syndrome comes into consideration as a differential diagnosis , the complaints diary is groundbreaking here. The histological examination of the small intestinal mucosa often reveals unspecific eosinophilic infiltrates . Villus atrophy, such as celiac disease, is less common, so malabsorption is also less common. It is therefore currently a diagnosis of exclusion :
"In the case of a wheat-dependent clinic and negative serology (for celiac disease-specific antibodies ), normal small intestine histology , negative specific IgE (wheat) and negative prick test (wheat)."
"In children and adolescents, non-celiac disease-non-wheat allergy-wheat sensitivity should be proven or excluded by double-blind , placebo- controlled exposure in order to avoid negative psychosocial and nutritional consequences of a strictly gluten-free diet."
literature
- German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS): Celiac disease, wheat allergy and wheat sensitivity ; Guideline; Status: April 30, 2014, valid until April 30, 2019, p. 42f.
- Maximilian Ledochowski: When bread and grain make you sick. Gluten intolerance, celiac disease - or what else? Trias, Stuttgart 2011, ISBN 978-3-8304-3776-5 .
Broadcast reports
- Lucian Haas : Wheat intolerance - The bad in bread , Deutschlandfunk - “ Science in focus ” from March 5, 2017