Abdominal Ultrasound Examination in Non-celiac Wheat Sensitivity
Condition: Non-celiac Wheat Sensitivity
MeSH terms: Hypersensitivity
Study type: Observational

Summary: 
      Recently it has been reported that a consistent percentage of the general population consider
      themselves to be suffering from problems caused by wheat and/or gluten ingestion, even though
      they do not have CD or wheat allergy. This clinical condition has been named Non-Celiac
      Gluten Sensitivity' (NCGS). In a previous paper the investigators suggested the term
      'Non-Celiac Wheat Sensitivity' (NCWS), since it is not known what component of wheat causes
      the symptoms in NCGS patients, and the investigators also showed that these patients had a
      high frequency of coexistent multiple food hypersensitivity. The clinical picture of NCWS is
      characterized by combined gastrointestinal (bloating, abdominal pain, diarrhea and/or
      constipation, nausea, epigastric pain, gastroesophageal reflux, aphthous stomatitis) and
      extra-intestinal and/or systemic manifestations (headache, depression, anxiety, 'foggy mind,'
      tiredness, dermatitis or skin rash, fibromyalgia-like joint/muscle pain, leg or arm numbness,
      and anemia). Nowadays no data are available on the abdominal ultrasonographic features of
      NCWS patients. Therefore, the aim of the present study is to evaluate the abdominal
      ultrasonographic features of NCWS patients in comparison with patients affected with celiac
      disease.
    

Detailed description: 
      Recently it has been reported that a consistent percentage of the general population consider
      themselves to be suffering from problems caused by wheat and/or gluten ingestion, even though
      they do not have CD or wheat allergy. This clinical condition has been named Non-Celiac
      Gluten Sensitivity' (NCGS). In a previous paper the investigators suggested the term
      'Non-Celiac Wheat Sensitivity' (NCWS), since it is not known what component of wheat causes
      the symptoms in NCGS patients, and the investigators also showed that these patients had a
      high frequency of coexistent multiple food hypersensitivity. The clinical picture of NCWS is
      characterized by combined gastrointestinal (bloating, abdominal pain, diarrhea and/or
      constipation, nausea, epigastric pain, gastroesophageal reflux, aphthous stomatitis) and
      extra-intestinal and/or systemic manifestations (headache, depression, anxiety, 'foggy mind,'
      tiredness, dermatitis or skin rash, fibromyalgia-like joint/muscle pain, leg or arm numbness,
      and anemia). The researchers have just demonstrated in patients affected with seronegative
      celiac disease that the presence of dilated bowel loops and a thickened small bowel wall had
      a sensitivity of 83% and a negative predictive value of 95% in CD diagnosis. Considering the
      presence of one of these two signs, abdominal US sensitivity increased to 92% and negative
      predictive value to 98%. Nowadays no data are available on the abdominal ultrasonographic
      features of NCWS patients. Therefore, the aim of the present study is to evaluate the
      abdominal ultrasonographic features of NCWS patients in comparison with patients affected
      with celiac disease.
    

Intervention name(s): Abdominal ultrasound examination
Intervention type(s): Other
Intervention description(s): All subjects undergone abdominal ultrasonography at the Outpatient of Ultrasonography of the Department of Internal Medicine at the University Hospital of Palermo, Italy.
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        The study included consecutive adult patients with IBS-like clinical presentation,
        according to Rome III criteria, and a definitive diagnosis of NCWS, referred at the
        Department of Internal Medicine at the University Hospital of Palermo, Italy, and at the
        Department of Internal Medicine of the Hospital of Sciacca, Agrigento, Italy, between
        January 2015 and November 2016, and sex- and age-matched subjects with CD, enrolled at the
        same centers, as controls patients. All subjects undergone abdominal ultrasonography at the
        Outpatient of Ultrasonography of the Department of Internal Medicine at the University
        Hospital of Palermo, Italy.
      
Keywords: Non-celiac wheat sensitivity; celiac disease; abdominal ultrasonography;