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Where’s the evidence for gluten sensitivity?

BMJ 2012; 345 doi: (Published 02 November 2012) Cite this as: BMJ 2012;345:e7360

Re: Where’s the evidence for gluten sensitivity?

Dr Elli must be congratulated upon his excellent, lucid overview about gluten sensitivity, a fashionable diagnosis which has to be accepted with caution.

Patients with irritable bowel syndrome (IBS) often relate their symptoms to the intake of some type of food and tend to identify some nutrients as the cause of meteorism and abdominal discomfort. Actually, especially in the case of bloating and early post-prandial diarrhoea, it is the intake of food itself, irrespective of its type, which triggers an exaggerated response by an overreacting colon to the physiological gastro-colonic reflex.

Until the alleged gluten sensitivity and the apparent beneficial effects of a gluten-free diet are better understood we should avoid labelling the symptoms of some functional patients as an elegant but questionable new diagnosis.

Competing interests: No competing interests

09 November 2012
Mario Guslandi
Division of Gastroenterology, S.Raffaele Hospital
Via Olgettina 60, Milan, Italy