Study details

For the study, researchers examined existing studies on non-celiac gluten sensitivity (NCGS). They found that the most common symptoms were bloating, abdominal pain, and fatigue.

Study leader Jessica Biesiekierski from the University of Melbourne said that recent evidence shows people with irritable bowel syndrome (IBS) who think they're gluten-sensitive often react in similar ways to gluten, wheat, and placebo. "This suggests that how people anticipate and interpret gut sensations can strongly influence their symptoms," she said.

As a result, the researchers said their findings suggest NCGS is part of the broader gut-brain interaction spectrum, similar to conditions like IBS — not an actual gluten disorder.

The researchers also found that most people with NCGS are likely not reacting to gluten but instead to fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs).

"Contrary to popular belief, most people with NCGS aren't reacting to gluten," Biesiekierski said. "Our findings show that symptoms are more often triggered by fermentable carbohydrates, commonly known as FODMAPs, by other wheat components or by people's expectations and prior experiences with food."

When the researchers compared different reactions in carefully controlled studies, they found that only a small number of participants showed actual gluten responses, and that overall, reactions weren't any different from those caused by a placebo.

A separate study, published in the United European Gastroenterology Journal also led by Biesiekierski, had similar findings. In that study, 16 participants with NCGS and 20 healthy controls received yogurt containing either 16 grams of gluten or whey protein. In addition, participants also ate two muffins every day for five days, which either contained eight grams of gluten or none.

Discussion

Biesiekierski said that the results of her studies have important consequences for how gut-related symptoms are managed and could influence not just medical diagnosis and dietary advice, but future public health messaging.

"Millions of people around the world avoid gluten believing it harms their gut, often after experiencing real symptoms that range from mild discomfort to severe distress," she said. "Improving our scientific and clinical understanding of a condition affecting up to 15 percent of the global population is incredibly important."

Jason Tye-Din, director of the Snow Centre for Immune Health and a gastroenterologist at the Royal Melbourne Hospital, said the updated understanding of NCGS will help providers better identify and treat the condition.

"Distinguishing NCGS from related gut conditions is essential for clinicians to offer accurate diagnosis and individualised care, as well as treating underlying drivers," Tye-Din said. "This review supports a more personalised, evidence-based approach to guy health and avoids unnecessary dietary restriction."

Biesiekierski added that successfully managing NCGS should combine dietary changes and psychological support while also maintaining proper nutrition.

"We would like to see public health messaging shift away from the narrative that gluten is inherently harmful, as this research shows that this often isn't the case," she said. "These findings additionally call for better diagnostic tools, more rigorous clinical pathways and research funding in this field, as well as improved public education and food labeling."