Nonceliac gluten-related disorders

Non-celiac wheat sensitivity (NCWS) is a new clinical condition which has recently been added alongside celiac disease and wheat allergy to the diseases due to wheat ingestion. Unlike these other two well-known conditions, however, NCWS still has no diagnostic biomarker and the variety of symptoms self-reported by the patients often confounds diagnosis. Furthermore, the NCWS clinical presentation overlaps with irritable bowel syndrome and with intolerance to Fermentable Oligo-, Di-, Mono- saccharides And Polyols (FODMAPs), making it difficult to distinguish between these diagnoses. In this complicated scenario, many aspects of NCWS - its frequency, pathogenesis, clinical symptoms, natural history and possible complications - have yet to be clarified and, above all, diagnostic biomarkers need to be found. In this chapter we summarize the scientific literature on NCWS, critically review the current conflicting evidence, and analyze future research areas to remove the veil of uncertainty covering all the ‘grey aspects’ of NCWS.