A major review led by researchers at the University of Melbourne has redefined non-coeliac gluten sensitivity (NCGS) as a gut–brain issue, rather than a gluten-related condition.
NCGS is a condition characterised by intestinal and extraintestinal symptoms related to the ingestion of gluten-based or wheat-based foods, in the absence of coeliac disease or wheat allergy.
The review found that most people who report symptoms after eating gluten do not actually react to gluten itself. Instead, symptoms such as bloating, gut pain, and fatigue are more often triggered by fermentable carbohydrates (FODMAPs), other wheat components, or by psychological factors like expectations and prior experiences.
In tightly controlled studies, only a small number of people with self-reported gluten sensitivity were found to have a physical reaction to gluten, with most responding similarly to gluten, wheat, or placebo. This evidence positions NCGS within the spectrum of gut–brain interaction disorders, rather than as a distinct gluten-related disorder.
The findings have significant implications for clinical practice and public health, highlighting the need for more accurate diagnosis, personalised treatment, and a shift away from unnecessary gluten avoidance. Effective management should combine dietary adjustments with psychological support, ensuring nutritional adequacy.
The review calls for improved diagnostic tools, more rigorous clinical pathways, and better public education to address misconceptions about gluten and gut health. This new understanding is expected to influence how clinicians, policymakers, and the public approach gluten sensitivity, supporting more personalised and evidence-based care for those with gut symptoms.
Read more about the research on the University of Melbourne website.
