Gut. 2025 Oct 28:gutjnl-2025-336304. doi: 10.1136/gutjnl-2025-336304. Online ahead of print.
ABSTRACT
BACKGROUND: Non-coeliac gluten/wheat sensitivity (NCGWS) is characterised by gastrointestinal and extraintestinal symptoms related to gluten or wheat ingestion in individuals without coeliac disease or wheat allergy.
OBJECTIVE: A systematic review and meta-analysis was conducted to estimate the global burden and clinical characteristics of self-reported NCGWS.
DESIGN: We searched for studies evaluating the prevalence of self-reported NCGWS in the general population. Pooled prevalence estimates and odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated using random-effects meta-analysis.
RESULTS: Twenty-five studies comprising 49 476 participants from 16 countries were included in the analysis. The pooled prevalence of self-reported NCGWS was 10.3% (95% CI 7.0% to 14.0%), with marked variations between countries. Among individuals reporting NCGWS, 40% (95% CI 25.2% to 55.0%) adhered to a gluten-free diet. The most common symptoms were bloating (71.0%; 95% CI 62.8% to 79.1%), abdominal discomfort (46.0%; 95% CI 39.0% to 52.7%), abdominal pain (36.0%; 95% CI 28.6% to 43.2%) and fatigue (32.1%; 95% CI 25.3% to 39.0%). Self-reported NCGWS was significantly more common in females than in males (OR 2.29; 95% CI 1.80 to 2.90; p<0.001). Individuals who self-reported NCGWS were significantly more likely to report anxiety (OR 2.95; 95% CI 1.56 to 5.57; p<0.001), depression (OR 2.42; 95% CI 1.80 to 3.24; p<0.001) and irritable bowel syndrome (OR 4.78; 95% CI 3.48 to 6.57; p<0.001) than controls.
CONCLUSION: Approximately one in 10 people worldwide self-report NCGWS, with a female predominance and a significant association with psychological distress and irritable bowel syndrome. Our findings suggest positioning NCGWS within the spectrum of disorders of gut-brain interaction once organic pathologies have been excluded.
PMID:41151790 | DOI:10.1136/gutjnl-2025-336304
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