The Role of a Gluten-free Diet in the Management of Celiac Disease and Non-Celiac Gluten Sensitivity: A Comparative Review
DOI:
https://doi.org/10.12775/QS.2026.62.73229Keywords
celiac disease, non-celiac gluten sensitivity, wheat allergy, gluten-free dietAbstract
Celiac disease (CD) and non-celiac gluten sensitivity (NCGS) have been a subject of interest in recent years. The CD is a chronic, gluten-dependent disease characterized by small bowel mucosal inflammation and injury and consequent malabsorption in genetically predisposed individuals. NCGS is characterized by the triggering of intestinal and/or extraintestinal symptoms after the consumption of products made with gluten-containing cereals. Gluten-free diet (GFD) is the only treatment to date of both these conditions.
The aim of this study is to evaluate the role of GFD as a therapeutic intervention in CD and NCGS. An extensive review of the literature was conducted using electronic databases (PubMed, Gastroenterology Journal, The Lancet Gastroenterology and Hepatology), and textbooks.
Although beneficial to many patients, GFD has many limitations, particularly it may lead to nutritional deficiencies and an imbalanced diet. In this review, the scope of these deficiencies was described and possible solutions were proposed.
References
1. Machado MV. New Developments in Celiac Disease Treatment. International Journal of Molecular Sciences. 2023;24(2):945. doi:https://doi.org/10.3390/ijms24020945
2. Satta PU, Giammarco Mocci, Lai M. FODMAP Diet in Celiac Disease and Gluten-Related Disorders. Nutrients. 2024;16(23):4190-4190. doi:https://doi.org/10.3390/nu16234190
3. Franziska Buriánek, Gege C, Petar Marinković. New developments in celiac disease treatments. Drug Discovery Today. 2024;29(9):104113-104113. doi:https://doi.org/10.1016/j.drudis.2024.104113
4. Cárdenas-Torres FI, Cabrera-Chávez F, Figueroa-Salcido OG, Ontiveros N. Non-Celiac Gluten Sensitivity: An Update. Medicina. 2021;57(6). doi:https://doi.org/10.3390/medicina57060526
5. Gadelha de Mattos Y, Puppin Zandonadi R, Gandolfi L, Pratesi R, Yoshio Nakano E, Pratesi C. Self-Reported Non-Celiac Gluten Sensitivity in Brazil: Translation, Cultural Adaptation, and Validation of Italian Questionnaire. Nutrients. 2019;11(4):781. doi:https://doi.org/10.3390/nu11040781
6. Zheng W, Yee C, Ka J, Cheng NS, Wing C, Leung TF. Routinely Used and Emerging Diagnostic and Immunotherapeutic Approaches for Wheat Allergy. Biomedicines. 2024;12(7):1549-1549. doi:https://doi.org/10.3390/biomedicines12071549
7. Borghini R, Spagnuolo A, Donato G, Borghini G. Gluten-Free Diet for Fashion or Necessity? Review with New Speculations on Irritable Bowel Syndrome-like Disorders. Nutrients. 2024;16(23):4236. doi:https://doi.org/10.3390/nu16234236
8. Ebo DG, Stevens WJ. IgE-mediated food allergy--extensive review of the literature. Acta Clinica Belgica. 2001;56(4):234-247. doi:https://doi.org/10.1179/acb.2001.035
9. Størdal K, Kurppa K. Celiac disease, non-celiac wheat sensitivity, wheat allergy – clinical and diagnostic aspects. Seminars in Immunology. 2025;77:101930. doi:https://doi.org/10.1016/j.smim.2025.101930
10. Aljada B, Zohni A, El-Matary W. The Gluten-Free Diet for Celiac Disease and Beyond. Nutrients. 2021;13(11). doi:https://doi.org/10.3390/nu13113993
11. Simón E, Molero-Luís M, Fueyo-Díaz R, Costas‐Batlle C, Crespo-Escobar P, Montoro M. The Gluten-Free Diet for Celiac Disease: Critical Insights to Better Understand Clinical Outcomes. Nutrients. 2023;15(18):4013-4013. doi:https://doi.org/10.3390/nu15184013
12. Schiepatti A, Maimaris S, Nicolardi ML, et al. Determinants and Trends of Adherence to a Gluten-Free Diet in Adult Celiac Patients on a Long-term Follow-up (2000–2020). Clinical Gastroenterology and Hepatology. Published online December 2020. doi:https://doi.org/10.1016/j.cgh.2020.12.015
13. Silvester JA, Therrien A, Kelly CP. Celiac Disease: Fallacies and Facts. American Journal of Gastroenterology. 2021;116(6):1148-1155. doi:https://doi.org/10.14309/ajg.0000000000001218
14. Talarico V, Giancotti L, Mazza GA, Miniero R, Bertini M. Iron Deficiency Anemia in Celiac Disease. Nutrients. 2021;13(5):1695. doi:https://doi.org/10.3390/nu13051695
15. Manza F, Lungaro L, Costanzini A, et al. Gluten and Wheat in Women’s Health: Beyond the Gut. Nutrients. 2024;16(2):322-322. doi:https://doi.org/10.3390/nu16020322
16. Manza F, Lungaro L, Costanzini A, et al. Non-Celiac Gluten/Wheat Sensitivity—State of the Art: A Five-Year Narrative Review. Nutrients. 2025;17(2):220. doi:https://doi.org/10.3390/nu17020220
17. Abdi F, Zuberi S, Blom JJ, Armstrong D, Pinto-Sanchez MI. Nutritional Considerations in Celiac Disease and Non-Celiac Gluten/Wheat Sensitivity. Nutrients. 2023;15(6):1475. doi:https://doi.org/10.3390/nu15061475
18. de G, Lawton CL, Croden F, et al. The effect of expectancy versus actual gluten intake on gastrointestinal and extra-intestinal symptoms in non-coeliac gluten sensitivity: a randomised, double-blind, placebo-controlled, international, multicentre study. The Lancet Gastroenterology & Hepatology. Published online November 1, 2023. doi:https://doi.org/10.1016/s2468-1253(23)00317-5
19. Zingone F, Bertin L, Maniero D, et al. Myths and Facts about Food Intolerance: A Narrative Review. Nutrients. 2023;15(23):4969-4969. doi:https://doi.org/10.3390/nu15234969
20. Calabriso N, Scoditti E, Massaro M, et al. Non-Celiac Gluten Sensitivity and Protective Role of Dietary Polyphenols. Nutrients. 2022;14(13):2679. doi:https://doi.org/10.3390/nu14132679
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Weronika Baginska, Natalia Pawelec, Jaśmina Podkościelna, Natalia Kasterka, Kamila Ryszkowska, Kinga Krzyżowska, Aleksandra Purska, Jagienka Perzynska, Urszula Załuska

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 91
Number of citations: 0