Non-coeliac wheat sensitivity (NCWS)

Non-coeliac wheat sensitivity (NCWS) refers to a symptomatic profile characterised by intolerance to components of wheat. The disease profile of NCWS has not been precisely defined, but affected patients report gastrointestinal symptoms (e.g. diarrhoea, abdominal pain, flatulence) or extraintestinal symptoms (e.g. headaches, exhaustion, light-headedness, joint and muscle pain, dermal changes, anaemia, depression) after the consumption of foods that contain gluten or other wheat proteins. Diagnosis of NCWS is initially based on a diagnosis of exclusion: Prior to a detailed investigation of the various forms of NCWS, the presence of coeliac disease or wheat allergy must be excluded with certainty.  Various components of wheat, e.g. gluten, fermentable oligosaccharides, disaccharide, monosaccharides and polyols (FODMAPs) or wheat germ agglutinins, may trigger NCWS.  No specific biomarkers are known to date. However, certain laboratory analyses may support the clinician in the diagnosis of NCWS and determining the cause of the wheat intolerance.