Worldwide prevalence of self-reported non-celiac wheat sensitivity (NCGWS)
Shiha MG et al, Gut. 2026;75(3):502-510
Results of this meta-analysis indicate that approximately one in 10 people worldwide self-report NCGWS, with a female predominance and a significant association with psychological distress and irritable bowel syndrome.
Background: Non-coeliac gluten/wheat sensitivity (NCGWS) is characterised by gastrointestinal and extraintestinal symptoms related to gluten or wheat ingestion in individuals without coeliac disease or wheat allergy.
Objective: A systematic review and meta-analysis was conducted to estimate the global burden and clinical characteristics of self-reported NCGWS.
Design: The authors searched for studies evaluating the prevalence of self-reported NCGWS in the general population. Pooled prevalence estimates and odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated using random-effects meta-analysis.
Results: Twenty-five studies comprising 49,476 participants from 16 countries were included in the analysis. The pooled prevalence of self-reported NCGWS was 10.3% (95% CI: 7.0–14.0%), with marked variations between countries. Among individuals reporting NCGWS, 40% (95% CI: 25.2–55.0%) adhered to a gluten-free diet. The most common symptoms were bloating (71.0%; 95% CI: 62.8–79.1%), abdominal discomfort (46.0%; 95% CI: 39.0–52.7%), abdominal pain (36.0%; 95% CI: 28.6–43.2%) and fatigue (32.1%; 95% CI: 25.3–39.0%). Self-reported NCGWS was significantly more common in females than in males (OR = 2.29; 95% CI: 1.80–2.90; p < 0.001). Individuals who self-reported NCGWS were significantly more likely to report anxiety (OR = 2.95; 95% CI: 1.56–5.57; p < 0.001), depression (OR = 2.42; 95% CI: 1.80–3.24; p < 0.001) and irritable bowel syndrome (OR = 4.78; 95% CI: 3.48–6.57; p < 0.001) than controls.
Conclusion: Approximately one in 10 people worldwide self-report NCGWS, with a female predominance and a significant association with psychological distress and irritable bowel syndrome. These findings suggest positioning NCGWS within the spectrum of disorders of gut-brain interaction once organic pathologies have been excluded.