Self-reported Gluten Sensitivity in High-school Students
Condition: Non-celiac Wheat Sensitivity
MeSH terms: Hypersensitivity
Study type: Observational

Summary: 
      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 celiac disease 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. To our knowledge, there
      are very few studies which assessed the prevalence of self-reported gluten-related symptoms
      in the community and analyze diagnostic outcomes in those referred to secondary
      gastrointestinal care. In one of these, performed in UK, the authors showed that
      gluten-related symptoms are self-reported by 13% of the population, with 3.7% consuming a
      gluten-free diet, despite only 0.8% being aware that they have a formal diagnosis of celiac
      disease. Of those patients presenting to the gastroenterology department, the majority do not
      have CD but NCWS. No data are available for boys and girls. Therefore, the aims of this study
      were 1) to determine the prevalence of self-perceived gluten-sensitivity in a population of
      high-school students, and 2) to evaluate the demographic and clinical differences between
      students self-reporting gluten sensitivity and students not reporting food hypersensitivity.
    

Detailed description: 
      Self-reported food hypersensitivity is common, particularly in women, with a reported
      prevalence of 20.4% in the UK community. A wide range of gastrointestinal and systemic
      symptoms may be experienced related to consumption of the intolerant food(s). In addition,
      patients demonstrate considerably more generalized subjective health complaints in comparison
      with healthy controls. In this context, 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 celiac disease 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). To our
      knowledge, there are few studies which assessed the prevalence of self-reported
      gluten-related symptoms in the community and analyze diagnostic outcomes in those referred to
      secondary gastrointestinal care. In one of these, performed in UK, the authors shown that
      gluten-related symptoms are self-reported by 13% of the population, with 3.7% consuming a
      gluten-free diet, despite only 0.8% being aware that they have a formal diagnosis of celiac
      disease. In this study individuals self-reporting gluten-related symptoms are predominantly
      female, report an association with IBS, and experience both intestinal and extraintestinal
      symptoms on gluten ingestion. Of those patients presenting to the gastroenterology
      department, the majority do not have CD but NCWS. In contrast to the above mentioned data,
      obtained in adults, no data are available for young people. Therefore, the aims of this study
      were 1) to determine the prevalence of self-perceived gluten-sensitivity in a population of
      high-school students, and 2) to evaluate the demographic and clinical differences between
      students self-reporting gluten sensitivity and students not reporting food hypersensitivity.
      The students participated in the study by filling out a modified version of a previously
      validated written questionnaire, to which there were two sections. The first comprised basic
      demographic information, including age, sex and ethnicity, and a screening section for
      symptoms consistent with irritable bowel syndrome (IBS) in accordance with the Rome III
      criteria, also including their past gastrointestinal, psychiatric and allergic history. The
      second section of the survey enquired for self-reported gluten-related symptoms. Participants
      were also asked for their use of a gluten-free diet and if they had seen a healthcare
      professional for their symptoms. A reported diagnosis of celiac disease and wheat allergy in
      the population group was defined by those who had a doctor diagnosis of celiac disease and
      wheat allergy and were also taking a gluten-free diet.
    

Intervention name(s): Questionnaire
Intervention type(s): Other
Intervention description(s): Administration of questionnaire.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        The study include high-school children, age range from 13 to 18 years, from "Liceo
        Classico" and "Liceo Artistico" "Tommaso Fazello" of Sciacca, Agrigento, Italy, evaluated
        by an ad hoc questionnaire between January 2016 and December 2016.
      
Keywords: Non-celiac wheat sensitivity; self-reported