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Non-celiac gluten sensitivity
Main article: Non-celiac gluten sensitivity

Non-celiac gluten sensitivity (NCGS) is described as a condition of multiple symptoms that improves when switching to a gluten-free diet, after celiac disease and wheat allergy are excluded.[42][43] Recognized since 2010,[44][45] it is included among gluten-related disorders,[44] but its pathogenesis is not yet well understood.[45] NCGS is the most common syndrome of gluten intolerance,[44][46] with a prevalence estimated to be 6-10%.[47]

People with NCGS may develop gastrointestinal symptoms, which resemble those of irritable bowel syndrome or wheat allergy,[44][48] and/or a wide variety of non-gastrointestinal symptoms, such as headache, chronic fatigue, fibromyalgia, atopic diseases, allergies, neurological diseases, or psychiatric disorders, among others.[39][45][49]

Besides gluten, additional components present in wheat, rye, barley, and their derivatives, including other proteins and short-chain carbohydrates called FODMAPs, may cause NCGS symptoms. The effects of FODMAPs are only limited to gastrointestinal discomfort.[45]

Anxiety Disorders

Various types of anxiety are associated with gluten intolerance. One study found that CD patients were significantly more likely to have state anxiety when compared to controls, and that after 1 year on a gluten-free diet, there was a significant improvement in state anxiety symptoms [31]. Other anxiety disorders such as social phobia and panic disorder have been linked to gluten response. Addolorato and colleagues [39] reported that a significantly higher proportion of CD patients had social phobia compared to normal controls. Additionally, a higher lifetime prevalence of panic disorder has been found in CD patients [33] and new studies have confirmed the increased association between CD and anxiety [40].

Depression and Mood Disorders

Depression and related mood disorders are reported to be associated with gluten sensitivity and celiac disease. One study found that major depressive disorder, dysthymic disorder, and adjustment disorders were more common in a group of CD patients compared to controls [33]. Increased prevalence of dysthymia in CD compared to controls was supported by a subsequent study [32]. Another study found that CD patients were more likely to be diagnosed with subsequent depression, but not bipolar disorder as compared to people without CD [41]. Ruuskanen et . [42] found that an elderly population with gluten sensitivity was more than twice as likely to have depression when compared to the elderly sample without GS. Corvaglia et . [43] have described improvement in depressive symptoms following a gluten-free diet.