Absence of somatization in non-coeliac gluten sensitivity

Abstract

Objective. In contrast to coeliac disease (CD), the mechanism behind non-coeliac gluten sensitivity (NCGS) is unclear. The aims of the study were to measure the presence of somatization, personality traits, anxiety, depression, and health-related quality of life in NCGS individuals compared with CD patients and healthy controls, and to compare the response to gluten challenge between NCGS and CD patients. Material and methods. We examined 22 CD patients and 31 HLA-DQ2+ NCGS patients without CD, all on a gluten-free diet. All but five CD patients were challenged orally for 3 days with gluten; symptom registration was performed during challenge. A comparison group of 40 healthy controls was included. Patients and healthy controls completed questionnaires regarding anxiety, depression, neuroticism and lie, hostility and aggression, alexithymia and health locus of control, physical complaints, and health-related quality of life. Results. The NCGS patients reported more abdominal (p = 0.01) and non-abdominal (p < 0.01) symptoms after gluten challenge than CD patients. There were no significant differences between CD and NCGS patients regarding personality traits, level of somatization, quality of life, anxiety, and depressive symptoms. The somatization level was low in CD and NCGS groups. Symptom increase after gluten challenge was not related to personality in NCGS patients. Conclusions. NCGS patients did not exhibit a tendency for general somatization. Personality and quality of life did not differ between NCGS and CD patients, and were mostly at the same level as in healthy controls. NCGS patients reported more symptoms than CD patients after gluten challenge.

Key Words::

• celiac disease
• food hypersensitivity
• gliadin
• irritable bowel syndrome
• personality
• psychosomatic medicine
• quality of life

Acknowledgments

We thank our gastroenterological colleagues who referred patients for the study, Anne Beate Hvinden for organizing patient appointments, Jorunn Bratlie for collection of samples, the staff at the Endoscopy Unit, Rikshospitalet, and especially all study participants for their contribution. The research was supported by the South-Eastern Norway Regional Health Authority, the University of Oslo, the Norwegian Coeliac Society and the Norwegian Society of Gastroenterology.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.