Non–celiac gluten sensitivity – the diagnosis of exclusion

The article describes all three sections of the classification of gluten-related disorders. From the very beginning of our presentation, the emphasis is placed on the section less covered in the medical literature, we are talking about non-celiac gluten sensitivity (NCCHG). According to international experts, the prevalence of this condition in the world is greater than celiac disease and wheat allergies. Triggers for the development of NCCHG in addition to gluten may be non–gluten proteins ATI – trypsin and amylase inhibitors. ATI is a group of several low molecular weight proteins that are highly resistant to proteolysis in the intestine. In wheat grains, ATI are in the gluten protein network. Gluten-free products do not contain ATI. The details of the clinical picture are given, both on the part of the intestine and extraintestinal symptoms. NCCHG is called «gluten-sensitive irritable bowel syndrome. The criteria of the Salt – diagnostic algorithm of the NCCHG are given. The following two parts provide information about celiac disease, an immunomediated systemic disease, and modern possibilities for its diagnosis, as well as describe wheat allergy options. Wheat contains more than three hundred proteins, three dozen of them are recognized as allergenic. Each section presents a clinical picture, diagnostic methods and treatment.

To diagnose NCCHG, it is necessary to establish the relationship of symptoms with gluten intake, prove the absence of serological markers of celiac disease and exclude wheat allergy. All these stages are described in the article.

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