Self-Reported Non-Celiac Wheat Sensitivity in High School Students: Demographic and Clinical Characteristics

Antonio Carroccio, Ornella Giambalvo, Francesco La Blasca, Rosario Iacobucci, Alberto D'Alcamo, Pasquale Mansueto, Antonio Carroccio, Ornella Giambalvo, Francesco La Blasca, Rosario Iacobucci, Alberto D'Alcamo, Pasquale Mansueto

Abstract

Background: Non-Celiac Wheat Sensitivity (NCWS) has recently been included among the gluten-related disorders. As no biomarkers of this disease exist, its frequency has been estimated based on self-reported symptoms, but to date no data are available about self-reported NCWS in teenagers.

Aim: To explore the prevalence of self-reported NCWS in a group of high school students and to study their demographic and clinical characteristics.

Methods: The study was performed between April 2015 and January 2016 in two high schools of a coastal town in the south of Sicily (Italy). A total of 555 students (mean age 17 years, 191 male, 364 female) completed a modified validated questionnaire for self-reported NCWS. The subjects who self-reported NCWS were then compared with all the others.

Results: Seven individuals (1.26%) had an established diagnosis of CD. The prevalence of self-reported NCWS was 12.2%, and 2.9% were following a gluten-free diet (GFD). Only 15 out of 68 (23%) NCWS self-reporters had consulted a doctor for this problem and only nine (14%) had undergone serological tests for celiac disease. The NCWS self-reporters very often had IBS symptoms (44%).

Conclusions: Self-reported NCWS was found to be common in teenagers, with a frequency of 12.2%; the frequency of GFD use was 2.9%, which was much higher than the percentage of known CD in the same population (1.26%). A greater awareness of the possible implications on the part of the subjects involved, and a more thorough medical approach to the study of self-reported wheat-induced symptoms are required.

Keywords: IBS; epidemiology; food allergy; non-celiac gluten-sensitivity; prevalence; self-reported non-celiac wheat sensitivity; teenagers.

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Symptoms caused by wheat ingestion in self-reported NCWS students (the percentage of subjects suffering from each symptom is shown). Multiple symptoms were reported in several subjects.
Figure 2
Figure 2
(A) Time lapse between wheat ingestion and symptom appearance in self-reported NCWS subjects; (B) Duration of the symptoms after wheat ingestion in subjects with self-reported NCWS.
Figure 3
Figure 3
Multiple correspondence analysis shows the relationship between some variables evaluated by the questionnaire including our variable of interest (self-reported NCWS). It identifies some similar groups of individuals following the parental social status (axis 1) and the gravity of symptoms (axis 2).

References

    1. Cooper B.T., Holmes G.K.T., Ferguson R., Thompson R.A., Allan R.N., Cooke W.T. Gluten-sensitive diarrhea without evidence of celiac disease. Gastroenterology. 1980;79:801–806.
    1. Sapone A., Bai J., Ciacci C., Dolinsek J., Green P.H., Hadjivassiliou M., Kaukinen K., Rostami K., Sanders D.S., Schumann M., et al. Spectrum of gluten-related disorders: Consensus on new nomenclature and classification. BMC Med. 2012;10:13. doi: 10.1186/1741-7015-10-13.
    1. Verdu E.F., Armstrong D., Murray J.A. Between celiac disease and irritable bowel syndrome: The no man’s land of gluten sensitivity. Am. J. Gastroenterol. 2009;104:1587–1594. doi: 10.1038/ajg.2009.188.
    1. Fasano A., Sapone A., Zevallos V., Schuppan D. Non-Celiac Gluten-Sensitivity. Gastroenterology. 2015;148:1195–1204. doi: 10.1053/j.gastro.2014.12.049.
    1. Tanpowpong P., Ingham T.R., Lampshire P.K., Kirchberg F.F., Epton M.J., Crane J., Camargo C.A., Jr. Coeliac disease and gluten avoidance in New Zealand children. Arch. Dis. Child. 2012;97:12–16. doi: 10.1136/archdischild-2011-300248.
    1. Di Giacomo D.V., Tennyson C.A., Green P.H., Demmer R.T. Prevalence of gluten-free diet adherence among individuals without celiac disease in the USA: Results from the continuous national health and nutrition examination survey 2009–2010. Scand. J. Gastroenterol. 2013;48:921–925. doi: 10.3109/00365521.2013.809598.
    1. Aziz I., Lewis N.R., Hadjivassiliou M., Winfield S.N., Rugg N., Kelsall A., Newrick L., Sanders D.S. A UK study assessing the population prevalence of self-reported gluten sensitivity and referral characteristics to secondary care. Eur. J. Gastroenterol. Hepatol. 2014;26:33–39. doi: 10.1097/01.meg.0000435546.87251.f7.
    1. Volta U., Bardella M.T., Calabro A., Troncone R., Corazza G.R. An Italian prospective multicenter survey on patients suspected of having Non-Celiac Gluten Sensitivity. BMC Med. 2014;12:85. doi: 10.1186/1741-7015-12-85.
    1. Golley S., Corsini N., Topping D., Morell M., Mohr P. Motivations for avoiding wheat consumption in Australia: Results from a population survey. Public Health Nutr. 2015;18:490–499. doi: 10.1017/S1368980014000652.
    1. Ontiveros N., Lopez-Gallardo J.A., Vergara-Jimenez M.J., Cabrera-Chavez F. Self-reported prevalence of symptomatic adverse reactions to gluten and adherence to gluten-free diet in an adult Mexican population. Nutrients. 2015;7:6000–6015. doi: 10.3390/nu7075267.
    1. Van Gils T., Nijeboer P., Jssennagger C.E., Sanders D.S., Mulder C.J., Bouma G. Prevalence and Characterization of Self-Reported Gluten Sensitivity in The Netherlands. Nutrients. 2016;8:714. doi: 10.3390/nu8110714.
    1. Longstreth G.F., Thompson W.G., Chey W.D., Houghton L.A., Mearin F., Spiller R.C. Functional bowel disorders. Gastroenterology. 2006;130:1480–1491. doi: 10.1053/j.gastro.2005.11.061.
    1. Abdi H., Valentin D. Multiple correspondence analysis. In: Salkind N., editor. Encyclopedia of Measurement and Statistics. Sage; Thousand Oaks, CA, USA: 2007.
    1. Catassi C., Elli L., Bonaz B., Bouma G., Carroccio A., Castillejo G., Cellier C., Cristofori F., de Magistris L., Dolinsek J. Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Expert Criteria. Nutrients. 2015;7:4966–4977. doi: 10.3390/nu7064966.
    1. Catassi C., Bai J.C., Bonaz B., Bouma G., Calabrò A., Carroccio A., Castillejo G., Ciacci C., Cristofori F., Dolinsek J. Non-Celiac Gluten-Sensitivity: The new frontier of gluten related disorders. Nutrients. 2013;5:3839–3853. doi: 10.3390/nu5103839.
    1. Carroccio A., D’Alcamo A., Iacono G., Soresi M., Iacobucci R., Arini A., Geraci G., Fayer F., Cavataio F., La Blasca F., et al. Persistence of Non-Celiac Wheat Sensitivity, based on long-term follow-up. Gastroenterology. 2017;153:56–58. doi: 10.1053/j.gastro.2017.03.034.
    1. Biesiekierski J.R., Newnham E.D., Shepherd S.J., Muir J.G., Gibson P.R. Characterization of adults with a self-diagnosis of Nonceliac Gluten Sensitivity. Nutr. Clin. Pract. 2014;29:504–509. doi: 10.1177/0884533614529163.
    1. Carroccio A., Mansueto P., Iacono G., Soresi M., D’Alcamo A., Cavataio F., Brusca I., Florena A.M., Ambrosiano G., Seidita A., et al. Non-Celiac Wheat Sensitivity diagnosed by double-blind placebo-controlled challenge: Exploring a new clinical entity. Am. J. Gastroenterol. 2012;107:1898–1906. doi: 10.1038/ajg.2012.236.
    1. Fritscher-Ravens A., Schuppan D., Ellrichmann M., Schoch S., Röcken C., Brasch J., Bethge J., Böttner M., Klose J., Milla P.J. Confocal endomicroscopy reveals food-associated changes in the intestinal mucosa of patients with irritable bowel syndrome. Gastroenterology. 2014;147:1012–1020. doi: 10.1053/j.gastro.2014.07.046.
    1. Carroccio A., Mansueto P., D’Alcamo A., Iacono G. Non-Celiac Wheat Sensitivity as an allergic condition: Personal experience and narrative review. Am. J. Gastroenterol. 2013;108:1845–1852. doi: 10.1038/ajg.2013.353.
    1. Gibson P.R., Shepherd S.J. Food choice as key management strategy for functional gastrointestinal symptoms. Am. J. Gastroenterol. 2012;107:657–666. doi: 10.1038/ajg.2012.49.
    1. Shepherd S.J., Lomer M.C., Gibson P.R. Short-chain carbohydrates and functional gastrointestinal disorders. Am. J. Gastroenterol. 2013;108:707–717. doi: 10.1038/ajg.2013.96.
    1. Molina-Infante J., Carroccio A. Suspected Non-Celiac Gluten Sensitivity confirmed in few patients after gluten challenge in double-blind, placebo-controlled trials. Clin. Gastroenterol. Hepatol. 2017;15:339–348. doi: 10.1016/j.cgh.2016.08.007.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe