Non-Coeliac Gluten Sensitivity (NCGS)
What is it and how do you test for it?
NCGS is a syndrome characterised by intestinal and extraintestinal symptoms related to the ingestion of gluten-containing food.
How is it diagnosed?
NCGS is diagnosed in patients when coeliac disease and wheat allergy have been eliminated yet the patient experiences symptoms after gluten consumption and symptoms dissipate upon the removal of gluten from the diet.
Symptoms of NCGS include but are not limited to:
- Bloating
- Diarrhoea
- Reflux
- Constipation
- Gastric pain
- Nausea
Extraintestinal symptoms of NCGS include:
- Brain fog
- Fatigue
- Depression
- Anxiety
- Headaches
- Muscle pain
- Dermatitis
Currently there are no specific markers for diagnosis, but we do have various tools that we can use to identify if this is the driver of your intestinal and extraintestinal symptoms.
There is a specific diagnosis protocol that can be followed if NCGS is suspected where we conduct a full work up, than run a gluten free diet where certain symptoms are monitored, following we run a blinded challenge utilising gluten in a FODMAP free form and placebo to solidify the validity of those results.
Coeliac disease and NCGS disease presentation is very different:
The mechanism of action that drives symptoms in NCGS is very different to what’s occurring in Coeliac disease therefore the same diagnostic measures can’t be utilised.
Markers that we can screen for to assist with diagnosis include:
- Elevated serum zonulin
- Elevated serum lipopolysaccharide-binding protein
- Elevated Anti-gliadin Antibody (AGA) IgG - elevated in ~50% of NCGS patients (these antibodies quickly normalises after GF diet).