Nonceliac Gluten Sensitivity Attributed to Fructan, Not Gluten

Many persons without celiac disease develop abdominal symptoms and sometimes nonspecific extra-abdominal symptoms after gluten ingestion.

In a double-blind, crossover study, researchers randomized 59 people with convincingly excluded celiac disease and wheat allergy to consume a gluten-free, low-FODMAP (fermentable oligo-, di-, and monosaccharides and polyols) muesli bar containing either added gluten (5.7 g) or fructan (2.1 g), or with nothing added (placebo), once daily for 7 days. Participants crossed over to the other conditions, eventually consuming all three bars. All participants were normally asymptomatic on a gluten-free diet to which they had adhered for 6 months.

Irritable bowel syndrome (IBS) scores, both overall and for bloating,…