Frequency and Clinical Aspects of Neurological and Psychiatric Symptoms in Patients with Non-Celiac Wheat Sensitivity.

Antonio Carroccio,Stella Compagnoni,Francesca Fayer,Maurizio Soresi,Ada Maria Florena,Daniele Castellucci,Alessandra Giuliano,Aurelio Seidita,Francesco La Blasca,Marta Chiavetta,Francesca Mandreucci,Pasquale Mansueto,Andrea Affronti

doi:10.3390/nu13061971

Abstract

Background: Non-Celiac Wheat Sensitivity (NCWS) is characterized by both intestinal and extra-intestinal symptoms. The study aims to investigate the frequency of neuropsychiatric manifestations in NCWS patients and identify their clinical and demographic characteristics. Methods: 278 clinical records of NCWS patients, diagnosed by a double-blind placebo-controlled wheat challenge between 2006 and 2020, were retrospectively revised. Fifty-two patients with Celiac Disease (CD) and 54 patients with Irritable Bowel Syndrome (IBS) served as controls. Results: 87% of the NCWS patients had an IBS-like clinical presentation. The NCWS group showed a longer duration of symptoms, a higher frequency of positive serum anti-nuclear antibodies than CD and IBS patients, and a higher frequency of DQ2/DQ8 haplotypes and duodenal mucosa lymphocytosis than IBS controls. In addition, 50% of NCWS patients showed neuropsychiatric manifestations, while lower percentages were observed in CD (25%) and IBS (28%) controls. Neuropsychiatric symptoms in NCWS were more frequently associated with the male sex, longer duration of symptoms, and IBS-diarrhea-like clinical presentation. Conclusions: Our data suggest that in patients with IBS-like symptoms and neuropsychiatric manifestations of unknown cause, it could be useful to investigate a correlation of these symptoms with wheat ingestion to identify NCWS patients with this ‘atypical’ manifestation.

Highlights

IntroductionAbdominal pain, bloating, and altered bowel habits motivate up to 25% of all outpatient gastroenterological visits [1]
Abdominal pain, bloating, and altered bowel habits motivate up to 25% of all outpatient gastroenterological visits [1]. This clinical presentation is common to Celiac Disease (CD), Non-Celiac Wheat Sensitivity (NCWS), and Irritable Bowel Syndrome (IBS); differential diagnosis can be challenging
Myalgia was recorded in 7.9% of NCWS patients with a decade of life [11,12,13,14,15], and the same trend of prevalence emerged from our study (females significantly higher frequency than in the CD and IBS control groups (p = 0.03 for both)

Summary

Introduction

Abdominal pain, bloating, and altered bowel habits motivate up to 25% of all outpatient gastroenterological visits [1]. This clinical presentation is common to Celiac Disease (CD), Non-Celiac Wheat Sensitivity (NCWS), and Irritable Bowel Syndrome (IBS); differential diagnosis can be challenging. IBS and NCWS can have an extra-intestinal presentation. It remains unclear why some patients with CD or NCWS have only gastrointestinal symptoms, while others primarily or exclusively suffer from extraintestinal manifestations. Non-Celiac Wheat Sensitivity (NCWS) is characterized by both intestinal and extra-intestinal symptoms. Methods: 278 clinical records of NCWS patients, diagnosed by a double-blind placebo-controlled wheat challenge between 2006 and 2020, were retrospectively revised. The NCWS group showed a longer duration of symptoms, a higher frequency of positive serum anti-nuclear antibodies than CD and IBS patients, and a higher frequency of DQ2/DQ8 haplotypes and duodenal mucosa lymphocytosis than

Methods

Discussion

Conclusion