Coeliac or Something Different? Part 2: Non-Coeliac Gluten Sensitivity — What We Know, What We Don’t, and Why Coeliac Testing Comes First

Learn pillar · Coeliac & Co. medical mini-series · Last verified 2026-09-13 · International English (UK · Ireland · US · Canada · Australia · New Zealand)

Non-coeliac gluten sensitivity (NCGS) describes gut and non-gut symptoms after eating gluten-containing food in people who do not have coeliac disease or wheat allergy. No test confirms it, in any country, so it is diagnosed by exclusion — which is exactly why coeliac disease has to be tested for first, while you are still eating gluten. The science is the same wherever you live. What changes by market is the name it goes by, how your patient society talks about it, and how much gluten your national guidance suggests keeping on the plate before the coeliac test. Here’s the unified picture, then the handful of places it genuinely differs.

This series is education, not diagnosis. If any of this sounds like you, the right next step is a conversation with your GP or primary-care doctor — ideally before you change anything about your diet. You’ll see why below.

Last time: IBS, the label coeliac disease most often hides behind. This time: the condition everyone argues about — “gluten intolerance”, “gluten sensitivity”, or its research name, non-coeliac gluten sensitivity.

NCGS is real to the people who live with it, it is not coeliac disease, and it is not wheat allergy. Beyond that the evidence is genuinely uncertain — and that uncertainty changes what a sensible first step looks like.

The short answer — and it’s the same everywhere

• There is no test for NCGS. No blood marker, no biopsy finding, no genetic result. That is true in the UK, Ireland, the US, Canada, Australia and New Zealand alike, because it is a fact about the science, not about any one health system. Coeliac UK says there are “no specific diagnostic tests”; Coeliac New Zealand puts it more bluntly: “There is NO specific gluten intolerance test!” (coeliac.org.uk; coeliac.org.nz — both last verified 2026-09-13.)
• It is diagnosed by ruling out coeliac disease and wheat allergy first — on a normal, gluten-containing diet. Every patient society in these six markets says the same thing, and so do the researchers who wrote the diagnostic criteria. (Catassi 2015; Coeliac UK; Celiac Disease Foundation; Canadian Celiac Association; Coeliac Australia; Coeliac New Zealand.)
• Whether gluten is even the trigger is an open question. In blinded studies, fructans — a carbohydrate in wheat, one of the FODMAPs — and plain placebo have produced as many symptoms as gluten. That research base (led from Monash University in Melbourne, used by dietitians worldwide) applies to every reader of this page. (Biesiekierski 2013; Skodje 2018; Molina-Infante 2017; Monash FODMAP FAQ.)
• What differs by market is small and practical: the spelling and the acronym, which society you’ll be signposted to, and what “keep eating gluten before the coeliac test” means in bread-slices-and-weeks according to your national guidance. Those are covered in their own sections below. Everything else in this article is the same guidance wherever you’re standing.

What NCGS is — and what it isn’t

Feature	Coeliac disease	Non-coeliac gluten sensitivity (NCGS)	Wheat allergy
Mechanism	Autoimmune: eating gluten makes the immune system attack the body’s own tissue.	Not coeliac disease and not an allergy; whether the immune system is involved at all is not yet clear.	An allergic immune reaction to wheat proteins, usually within seconds or minutes (hives, swelling, breathing trouble in serious cases).
Antibodies & test	Specific antibodies in the blood (tTG-IgA, with total IgA) — it leaves fingerprints.	No antibodies and no biomarker of any kind: no blood, biopsy or genetic test confirms it.	A separate allergy test route (covered in Part 3).
Damage to the gut	Yes — damage to the small intestine, visible on biopsy.	None apparent — no damage to the gut lining.	Covered in Part 3 of this series.
How it’s diagnosed	Blood test while you’re still eating gluten, then a specialist referral for a small-bowel biopsy to confirm.	By exclusion — only once coeliac disease and wheat allergy are ruled out, on a normal gluten-containing diet; formally, a blinded gluten challenge with your medical team.	A different test route (covered in Part 3).
Treatment	A lifelong strict gluten-free diet; even small traces have to be avoided.	A supervised trial of removing and reintroducing gluten with your medical team; trace amounts may well be tolerated.	Covered in Part 3 of this series.

Not coeliac disease. Coeliac disease is autoimmune: eat gluten and your immune system attacks your own tissue, damaging the small intestine. It leaves fingerprints — specific antibodies in the blood, visible damage on biopsy. NCGS leaves neither: no antibodies are produced and there does not appear to be damage to the gut lining. Whether the immune system is involved at all is not yet clear. (NHS; Coeliac UK; NIDDK; Sapone 2012.)

Not wheat allergy. A wheat allergy is an immune reaction to wheat proteins, usually within seconds or minutes — hives, swelling, breathing trouble in serious cases. Part 3 of this series is that story. (Coeliac UK; NHS food allergy page.)

So what is it? A 2012 expert consensus sorted gluten-related conditions into three groups: autoimmune (coeliac disease), allergic (wheat allergy), and a third where both have been ruled out. That third group is NCGS: gut and non-gut symptoms after gluten-containing food, overlapping heavily with undiagnosed coeliac disease. In the research so far, no major complication of untreated NCGS has been described, and the autoimmune company coeliac disease keeps has not been reported — the most reassuring line in this article. (Sapone 2012; Catassi 2013; Catassi 2015.)

Why the distinction matters in daily life. Coeliac New Zealand makes a point the whole field agrees on: a person with coeliac disease must avoid even small traces of gluten, whereas someone with NCGS “may well be able to tolerate these trace amounts” — and gluten damages the coeliac gut whether or not it causes symptoms. Same diet on the surface; very different rules underneath. That is the practical reason the label needs to be right. (coeliac.org.nz, last verified 2026-09-13.)

One condition, several names — by market

This is the first genuine regional difference, and it’s about words, not biology.

• UK, Ireland, Australia, New Zealand: “coeliac”, and the research term non-coeliac gluten sensitivity (NCGS). Coeliac Australia and Coeliac New Zealand both add the lay phrase — “non-coeliac gluten sensitivity, or gluten intolerance” — because that is how most people arrive at the topic. (coeliac.org.au; coeliac.org.nz, last verified 2026-09-13.)
• US: “celiac”, and the Celiac Disease Foundation uses non-celiac gluten sensitivity (NCGS) and non-celiac wheat sensitivity (NCWS) interchangeably — the “wheat” version reflecting the open question of whether gluten or another wheat component is doing the work. (celiac.org, last verified 2026-09-13.)
• Canada: “celiac”, and the Canadian Celiac Association’s own page runs the two together as non-celiac gluten/wheat sensitivity (NCGWS). (celiac.ca, last verified 2026-09-13.)

Whichever acronym you meet, it is the same condition, defined the same way, with the same absence of a test. If a clinic or a label uses “gluten intolerance”, read it as the same thing — and remember that none of these terms is a diagnosis you can give yourself.

What we know, and what we honestly don’t

No biomarker. No blood test, no biopsy finding, no marker of any kind confirms NCGS. Coeliac UK says it plainly: there are no specific diagnostic tests. The 2015 expert group that wrote the diagnostic criteria (the “Salerno criteria”) opened with the same admission. (Coeliac UK; Catassi 2015.)

Diagnosis by exclusion — and then some. NCGS is diagnosed by ruling out coeliac disease and wheat allergy on a normal, gluten-containing diet, then watching what happens when gluten is removed and reintroduced. The research version is a double-blind, placebo-controlled challenge — neither you nor the clinician knows which week contained gluten — because, as the Salerno authors put it, NCGS “should not be an exclusion diagnosis only”. (Catassi 2015.)

How common? Nobody knows. Published estimates range from well under 1% to several percent, and their own authors call the true figure unknown. The Canadian Celiac Association notes about 10% of people self-report sensitivity to gluten or wheat — a very different number from a diagnosed rate, which is the whole point. (Catassi 2013; Catassi 2015; celiac.ca “epistemic humility” post, last verified 2026-09-13.)

Is it even the gluten? This is the live question, and blinded challenges keep surprising the researchers:

• 2013: 37 people with self-reported gluten sensitivity went low-FODMAP first, then were challenged blind with gluten, low gluten or whey. Symptoms worsened similarly whatever was added back; a gluten-specific effect appeared in 8%. (Biesiekierski 2013.)
• 2018: 59 people with self-reported NCGS had a blinded week each of gluten, fructans (a carbohydrate in wheat) and placebo. Fructans produced the highest symptom scores; gluten did not differ meaningfully from placebo. (Skodje 2018.)
• 2017: a review of ten blinded trials found only 16% of people with suspected NCGS reacted specifically to gluten — and 40% reacted to the placebo. (Molina-Infante 2017.)

Coeliac UK acknowledges the same debate — gluten, or the FODMAPs and non-gluten wheat proteins that leave the diet with it. Coeliac Australia goes a step further for people with IBS-type symptoms: “While gluten is often blamed, the malabsorption of fermentable sugars (FODMAPs) is a more likely cause in those with IBS.” (coeliac.org.uk; coeliac.org.au — both last verified 2026-09-13.)

Our lane is coeliac disease, so we’ll say this carefully: none of that means anyone’s symptoms are imaginary. It does mean “I feel better without gluten” has more than one possible explanation — and that FODMAP questions belong with a dietitian working from the Monash approach, not with us. That advice does not change by country: the Monash low-FODMAP programme is the reference dietitians use in all six of these markets, and fructans are found in wheat, rye, onion and garlic wherever they’re grown. (Monash FODMAP FAQ, last verified 2026-09-13.)

Why coeliac testing comes first — while you’re still eating gluten

Coeliac disease and NCGS look the same from the outside, but only one can be tested for directly — and that test only works while gluten is on the plate. This principle is universal; every society and guideline we checked in all six markets states it in its own words:

• Coeliac UK does not recommend a gluten-free diet as a first option when you have symptoms, because it could stop the coeliac test giving an accurate result. NICE NG20 goes further: eat gluten in more than one meal every day for at least six weeks before testing, and do not start a gluten-free diet until a specialist confirms the diagnosis — even after a positive blood test. The NHS puts it in one line: include gluten in your diet when the blood test is done. (coeliac.org.uk; NICE NG20 via NCBI Bookshelf; nhs.uk — all last verified 2026-09-13.)
• Coeliac Society of Ireland: “Never cut out gluten ‘just to see’ if someone might have coeliac disease. Always test first.” (coeliac.ie FAQ, last verified 2026-09-13.)
• NIDDK (US): doctors don’t recommend starting a gluten-free diet before diagnostic testing, because a gluten-free diet can affect test results. (niddk.nih.gov, last verified 2026-09-13.)
• Canadian Celiac Association: the diagnosis of NCGWS “requires excluding celiac disease first”, and “a gluten/wheat-free diet should NOT be started before screening for celiac disease.” (celiac.ca, last verified 2026-09-13.)
• Coeliac Australia: “only once coeliac disease and other medical conditions have been excluded should other dietary triggers for symptoms be explored.” (coeliac.org.au, last verified 2026-09-13.)
• Coeliac New Zealand: it is “vital to continue eating gluten … until the diagnosis of coeliac disease is confirmed (which for most people will be after the scope test).” (coeliac.org.nz, last verified 2026-09-13.)

Skip that order and you land in the limbo Part 1 described: feeling better, no diagnosis, no follow-up, no family screening — and a gluten challenge if you ever want an answer. Even the NCGS researchers say it: a full evaluation can only start in someone still eating gluten. (Catassi 2015.)

The stakes are not symmetrical. Untreated coeliac disease damages the small intestine, with consequences beyond the gut; a diagnosis unlocks monitoring, dietitian support and testing for relatives — around 1 in 10 close relatives of someone with coeliac disease will be at risk themselves. NCGS, on current evidence, does neither. Ruling out the serious one first is simply the right order. (NIDDK; NHS; NICE NG20; Coeliac UK screening page.)

What “keep eating gluten” means, market by market

Here is the second real regional difference. The principle — stay on gluten until the coeliac work-up is complete — is identical everywhere. The published rule of thumb for how much and for how long is not, because each national body has written its own. None of these is a prescription from us; they are what your own national guidance says, so you can recognise it when your doctor mentions it. The amount and duration that apply to you are set by your GP or gastroenterologist, not by this page.

• UK (NICE NG20): gluten in more than one meal every day, for at least six weeks, before testing. (NICE NG20 via NCBI Bookshelf, last verified 2026-09-13.)
• Ireland (Coeliac Society of Ireland): the society’s Getting Diagnosed page says “four slices of ordinary bread a day for six weeks or more should be sufficient”; its FAQ page says “at least 2 slices of ordinary bread everyday for six weeks”. The six weeks is the constant; the slice count differs between the society’s own two pages, so take the figure from your GP. (coeliac.ie, both pages last verified 2026-09-13.)
• US (NIDDK): the federal guidance states the principle — don’t start a gluten-free diet before testing — without publishing a slices-and-weeks figure on its diagnosis page. Your gastroenterologist sets the challenge if you need one. (niddk.nih.gov, last verified 2026-09-13.)
• Canada (Canadian Celiac Association): two published approaches for adults — a “classical” challenge of 6–10 g of gluten a day (about 2–3 slices of wheat bread) for 6–8 weeks, and a “modified” challenge of 3 g a day (about 1.5 slices) for at least six weeks, with a repeat blood test along the way and referral to a gastroenterologist if the tTG-IgA is positive. (celiac.ca gluten-challenge page, last verified 2026-09-13.)
• Australia (Coeliac Australia): if you’ve been avoiding gluten for more than around six weeks before testing, you’ll need to reintroduce it for the results to be reliable. (coeliac.org.au, last verified 2026-09-13.)
• New Zealand (Coeliac New Zealand): a gluten challenge means “a minimum of 4 slices of wheat-based bread or equivalent” daily for 4–8 weeks before testing (two slices daily for a month for children). (coeliac.org.nz, last verified 2026-09-13.)

Notice what those six lines have in common: six weeks turns up in five of them, and “keep eating it until the specialist says testing is complete” in all six. The differences are in the detail of the bread count, not in the direction of travel.

The referral pathway — the same shape in all six markets

We checked whether the route to a diagnosis differs by country. In substance it doesn’t: a first-line blood test (tTG-IgA, with total IgA; Australia’s guidance pairs it with DGP-IgG), ordered by your GP, family doctor or primary-care provider, then referral to a gastroenterologist for a small-bowel biopsy to confirm. NICE requires specialist confirmation in the UK; the American College of Gastroenterology’s 2023 guideline says intestinal biopsy “is required in most patients to confirm the diagnosis”; the Coeliac Society of Ireland, Coeliac Australia and Coeliac New Zealand describe the same GP → blood test → gastroenterologist → biopsy sequence. (NICE NG20; Rubio-Tapia 2023; coeliac.ie; coeliac.org.au; coeliac.org.nz — all last verified 2026-09-13.)

Two honest footnotes. First, the word for the first doctor changes — “GP” in the UK, Ireland, Australia and New Zealand; “family doctor” or “primary care provider” in Canada and the US — but the role is the same. Second, the fine print on who can be diagnosed without a biopsy is evolving and differs between guidelines; that is a specialist decision, outside the scope of this article, and it doesn’t change the order: test for coeliac disease first, on gluten, before anyone talks about NCGS.

What to do with your medical team

This part is the same everywhere.

• Ask directly: “Have I been tested for coeliac disease?” Keep eating your normal diet until your GP or doctor says testing is complete.
• Mention allergy-type symptoms — reactions within minutes, hives, swelling, wheezing. That points to a different test route.
• If both are ruled out, the NCGS conversation happens with your GP, gastroenterologist or dietitian as a supervised trial of removing and reintroducing foods — never a solo elimination diet; the NHS says don’t cut foods out without GP or dietitian advice, and the Canadian and Australian societies say the same in their own words. (nhs.uk food intolerance page; celiac.ca; coeliac.org.au.)
• Already gluten-free without a test? Tell your GP. The gluten challenge exists for exactly this, it can be difficult, and it is a decision to make together. (Coeliac UK, how-is-coeliac-disease-diagnosed page.)

Where to turn afterwards — your patient society, by market

Patient societies are signposts, not diagnostic authorities — none of them will diagnose you, and neither will we. But they are the best allies for the follow-up, and each of these has its own NCGS or diagnosis page written for its own health system:

• UK — Coeliac UK. Its gluten-sensitivity page is the clearest short statement in English of “no specific diagnostic tests” and “don’t try a gluten-free diet first”.
• Ireland — Coeliac Society of Ireland. Diagnosis pathway and gluten-before-testing guidance on its Getting Diagnosed and FAQ pages.
• US — Celiac Disease Foundation (NCGS/NCWS page) and the National Celiac Association. (Beyond Celiac also publishes an NCGS page; its site blocked our verification fetch today, so we don’t quote it.)
• Canada — Canadian Celiac Association (Celiac Canada). NCGWS page plus a gluten-challenge page written for physicians.
• Australia — Coeliac Australia. Diagnosis page with the six-week reintroduction note; NCGS covered on its coeliac-disease overview.
• New Zealand — Coeliac New Zealand. A dedicated NCGS page and a Tests & Diagnosis page with the gluten-challenge figures above.
• Reading this from Germany, Italy or Switzerland? The German and Italian editions of this article carry the DZG and AIC signposts respectively; the science and the order of testing are identical.

And the food-positive bit. Whatever the label turns out to be, the plate doesn’t shrink. Rice, potatoes, corn, buckwheat, lentils, eggs, fish, vegetables, cheese — the naturally gluten-free half of every cuisine was never an adaptation. Get the diagnosis in the right order, and the eating part gets simpler.

FAQ

Is non-coeliac gluten sensitivity the same as coeliac disease?
No. Coeliac disease is autoimmune — specific antibodies, damage to the small intestine, lifelong strict gluten-free diet. NCGS has no antibodies and no visible gut damage, and is only considered once coeliac disease and wheat allergy have been excluded. That definition is the same in every country.

Is there a test for gluten sensitivity?
Not at present, anywhere. No biomarker exists; NCGS is diagnosed by exclusion and, in the formal criteria, by a blinded gluten challenge — with your medical team, after coeliac disease and wheat allergy have been ruled out.

I feel better without gluten — doesn’t that prove it?
Not on its own. In blinded studies many people reacted to fructans or to placebo rather than gluten. And if you cut gluten before coeliac testing, the test may miss coeliac disease. Ask your GP about testing first.

Is “gluten intolerance” the same thing as NCGS?
In everyday use, yes — Coeliac Australia and Coeliac New Zealand use the two phrases side by side, and the US and Canadian societies add “wheat” to the name (NCWS / NCGWS) because the trigger may not be gluten at all. Different words, one condition, still no test.

How long do I have to keep eating gluten before a coeliac test?
Your doctor decides, but national guidance gives a rule of thumb: at least six weeks in the UK (NICE), Ireland, Canada’s modified challenge and Australia’s reintroduction note; four to eight weeks in New Zealand; the US guidance states the principle without a published figure. The bread-slice counts vary by society; the “don’t stop until testing is complete” rule does not.

Does the diagnosis route differ by country?
Not in shape. In all six markets it runs GP or primary-care doctor → coeliac blood test → gastroenterologist → biopsy to confirm, and only after that does the NCGS conversation begin.

---

Related on How to Gluten Free

• Coeliac or Something Different? Part 1: IBS — the label coeliac disease most often hides behind, and the order of testing
• Coeliac or Something Different? Part 3: Wheat allergy — the fast one, and why it’s the odd one out
• The Coeliac Alphabet: Autoimmune — why coeliac disease leaves fingerprints and NCGS doesn’t
• Men Get Coeliac Too — the “don’t go gluten-free first” rule from the other side of the consulting-room door
• Beginners Guide hub — diagnosed and finding your feet: start here
• Our methodology — how we source, date and re-check the clinical claims on this page

---

Sources

• Coeliac UK, “Gluten sensitivity.” Backs: no specific diagnostic tests; no antibodies/gut damage; GF diet not a first option; the FODMAP/non-gluten-wheat-protein debate. — https://www.coeliac.org.uk/about-coeliac-disease/related-conditions/gluten-sensitivity/
• Coeliac UK, “How is coeliac disease diagnosed?” and “Screening for coeliac disease.” Backs: the gluten challenge and the 1-in-10 relatives figure. — https://www.coeliac.org.uk/about-coeliac-disease/how-is-coeliac-disease-diagnosed/ ; https://www.coeliac.org.uk/information-and-support/coeliac-disease/getting-diagnosed/screening-for-coeliac-disease/
• NICE NG20, Coeliac disease: recognition, assessment and management (2015), via NCBI Bookshelf NBK343373. Backs: >1 meal/day for ≥6 weeks; specialist confirmation before a GF diet. nice.org.uk/guidance/ng20 returned 403 on 2026-09-01, 09-02 and 09-13; the Bookshelf copy is NICE’s own guideline text. — https://www.ncbi.nlm.nih.gov/books/NBK343373/
• NHS, “Coeliac disease — Diagnosis” and “Food intolerance.” Backs: include gluten when the blood test is done; don’t cut foods out without GP/dietitian advice. — https://www.nhs.uk/conditions/coeliac-disease/diagnosis/ ; https://www.nhs.uk/conditions/food-intolerance/
• NHS, “Coeliac disease” (overview) and “Food allergy.” Backs: autoimmune definition; wheat allergy test route. — https://www.nhs.uk/conditions/coeliac-disease/ ; https://www.nhs.uk/conditions/food-allergy/
• Coeliac Society of Ireland, “Getting Diagnosed” and “Frequently Asked Questions.” Backs: Irish GP → gastroenterologist → biopsy pathway; “always test first”; the two slice-count figures. — https://coeliac.ie/getting-diagnosed/ ; https://coeliac.ie/frequently-asked-questions/
• NIDDK (US), “Definition & Facts for Celiac Disease” and “Diagnosis of Celiac Disease.” Backs: gluten sensitivity does not damage the small intestine; don’t start a GF diet before testing. — https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease/definition-facts ; https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease/diagnosis
• Celiac Disease Foundation (US), “Non-Celiac Gluten/Wheat Sensitivity.” Backs: NCGS/NCWS terminology; diagnosis after negative coeliac and wheat-allergy testing. — https://celiac.org/about-celiac-disease/related-conditions/non-celiac-wheat-gluten-sensitivity/
• Rubio-Tapia A, et al., “American College of Gastroenterology Guidelines Update: Diagnosis and Management of Celiac Disease,” Am J Gastroenterol 2023. PMID 36602836 (abstract via Europe PMC). Backs: biopsy required in most patients to confirm. — https://europepmc.org/article/MED/36602836
• Canadian Celiac Association, “Non-Celiac Gluten Sensitivity,” “Gluten Challenge,” and “Navigating non-celiac gluten sensitivity: epistemic humility.” Backs: NCGWS terminology; exclude celiac disease first; challenge amounts/durations; ~10% self-report. — https://www.celiac.ca/gluten-related-disorders/non-celiac-gluten-sensitivity/ ; https://www.celiac.ca/healthcare-professionals/diagnosis/gluten-challenge/ ; https://www.celiac.ca/non-celiac-gluten-sensitivity-epistemic-humility/
• Coeliac Australia, “Coeliac disease” and “Diagnosis.” Backs: NCGS “or gluten intolerance”; FODMAPs more likely in IBS; exclude coeliac disease first; six-week reintroduction; tTG-IgA + DGP-IgG; GP → gastroenterologist. — https://coeliac.org.au/learn/coeliac-disease/ ; https://coeliac.org.au/learn/diagnosis/
• Coeliac New Zealand, “Non-coeliac Gluten Sensitivity” and “Tests & Diagnosis.” Backs: no gluten-intolerance test; trace-tolerance distinction; continue gluten until after the scope; 4 slices for 4–8 weeks. — https://coeliac.org.nz/non-coeliac-gluten-sensitivity/ ; https://coeliac.org.nz/get-diagnosed/
• Monash University, FODMAP FAQ. Backs: fructans found in wheat, rye, onion and garlic; fructans = oligosaccharide/FODMAP. — https://www.monashfodmap.com/about-fodmap-and-ibs/frequently-asked-questions/
• Sapone A, et al., “Spectrum of gluten-related disorders: consensus on new nomenclature and classification,” BMC Med 2012. Backs: the three-group classification; no biomarker. — https://pmc.ncbi.nlm.nih.gov/articles/PMC3292448/
• Catassi C, et al., “Non-Celiac Gluten Sensitivity: The New Frontier of Gluten Related Disorders,” Nutrients 2013. Backs: prevalence unknown (0.5–6%); no complications/autoimmune comorbidity reported. — https://pmc.ncbi.nlm.nih.gov/articles/PMC3820047/
• Catassi C, et al., “Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts’ Criteria,” Nutrients 2015. Backs: definition; no biomarker; blinded challenge; evaluation only on gluten. — https://pmc.ncbi.nlm.nih.gov/articles/PMC4488826/
• Biesiekierski JR, et al., Gastroenterology 2013. Backs: 37 participants, no gluten-specific effect after low-FODMAP; 8%. — https://europepmc.org/article/MED/23648697
• Molina-Infante J, Carroccio A, Clin Gastroenterol Hepatol 2017. Backs: 16% gluten-specific; 40% nocebo. — https://europepmc.org/article/MED/27523634
• Skodje GI, et al., Gastroenterology 2018. Backs: 59 participants; fructans > gluten; gluten ≈ placebo. — https://europepmc.org/article/MED/29102613

We inform; we don’t diagnose or prescribe. Non-coeliac gluten sensitivity, coeliac disease and wheat allergy are medical questions — how much gluten to eat before a test, which tests to have and what your results mean belong with your GP, gastroenterologist or dietitian, in whichever country you’re standing.