Der Gastroenterologe

, Volume 10, Issue 6, pp 498–502 | Cite as

Nicht-Zöliakie-Weizensensitivität

Schwerpunkt: Zöliakie und Darmlymphome
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Zusammenfassung

Hintergrund

Weizen wird auch unabhängig vom Vorliegen einer Zöliakie oder Weizenallergie als möglicher Auslöser gastrointestinaler Beschwerden diskutiert.

Ziel der Arbeit

Darstellung des Kenntnisstands zu Ursachen, Häufigkeit, Symptomatik, Diagnostik und Therapie der Nicht-Zöliakie-Weizensensitivität.

Material und Methoden

Auswertung und Diskussion von Grundlagenarbeiten und Expertenempfehlungen.

Ergebnisse

Nicht-Zöliakie-Weizensensitivität ist ein aktuell nur klinisch definiertes Syndrom unklarer Genese, das bei mindestens 1 % der Bevölkerung und bei etwa einem Drittel der Reizdarmpatienten vorzuliegen scheint. Es treten intestinale Beschwerden wie beim Reizdarmsyndrom, aber auch unspezifische extraintestinale Symptome auf. Diagnostisch wegweisend sind nach Ausschluss von Zöliakie und Weizenallergie das Verschwinden der Beschwerden unter weizenfreier Diät und ihr schnelles Wiederauftreten bei erneutem Weizenverzehr. Art und optimale Dauer der Diät sind noch unklar, bei längerer Beschwerdefreiheit könnte ein Auslassversuch erfolgen.

Schlussfolgerungen

Wegen der guten diätetischen Behandlungsmöglichkeiten sollte trotz bestehender Unklarheiten bei entsprechenden intestinalen und extraintestinalen Beschwerden die Nicht-Zöliakie-Weizensensitivität als mögliche Ursache berücksichtigt werden.

Schlüsselwörter

Reizdarm Diarrhö Weizenallergie Glutene FODMAP 

Non-celiac wheat sensitivity

Abstract

Background

Wheat may cause gastrointestinal symptoms in the absence of celiac disease or wheat allergy.

Objectives

Current knowledge of causes, epidemiology, symptoms, diagnosis, and therapy of nonceliac wheat sensitivity is presented.

Materials and methods

Basic literature and expert opinions are analyzed and discussed.

Results

Non-celiac wheat sensitivity is a clinically defined syndrome of unknown origin and seems to occur in at least 1 % of the population and in about one-third of patients with irritable bowel syndrome. Patients have intestinal symptoms like in irritable bowel syndrome, but also unspecific extraintestinal symptoms. After exclusion of celiac disease and wheat allergy, the diagnosis is established by the disappearance of symptoms on a wheat-free diet and their rapid recurrence following renewed wheat ingestion. Type and optimum duration of dietary therapy are unclear, but a diet break could be tried in long-term asymptomatic patients.

Conclusions

Given the excellent dietary treatment options, non-celiac wheat sensitivity – despite existing uncertainties – should be considered in patients with the respective intestinal and extraintestinal symptoms.

Keywords

Irritable bowel syndrome Diarrhea Wheat allergy Glutens FODMAP 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Institut für klinische Physiologie und Medizinische Klinik mit Schwerpunkt Gastroenterologie, Infektiologie und RheumatologieCampus Benjamin Franklin, Charité – Universitätsmedizin BerlinBerlinDeutschland
  2. 2.Medizinische Klinik mit Schwerpunkt Gastroenterologie, Infektiologie und RheumatologieCampus Benjamin Franklin, Charité – Universitätsmedizin BerlinBerlinDeutschland

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