Gluten Is Not the Culprit in Many Patients' Symptoms


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Am Fam Physician. 2016 May 1;93(9):788.

Clinical Question

Can patients with nonceliac gluten sensitivity tell when they are exposed to gluten?

Bottom Line

Gluten may not be the cause of gastrointestinal symptoms in many patients with nonceliac gluten sensitivity. Only one-third of patients on a gluten-free diet experienced symptoms and correctly identified when they were given gluten-containing flour. Almost one-half (49%) of patients experienced symptoms even though they were given gluten-free flour. (Level of Evidence = 1b−)


Although the incidence of celiac disease—with resulting gluten sensitivity—is approximately 0.4%, many persons who do not have antibodies to gluten identify symptoms when they eat gluten-containing foods. The r

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP,search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.


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Oct 15, 2016

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