What Is NCGS?
Non?Coeliac Gluten Sensitivity, sometimes called gluten intolerance, describes discomfort after eating gluten—even when someone doesn’t have coeliac disease or a wheat allergy. Symptoms include stomach pain, bloating, diarrhoea or constipation, and may also cause fatigue, headache, joint pain, anxiety or depression.
Unlike coeliac disease, NCGS does not involve autoimmune damage to the small intestine, have coeliac-specific antibodies, or carry the HLA-DQ2 or HLA-DQ8 genes. Diagnosis is based on exclusion, often after coeliac disease and wheat allergy have been ruled out by a healthcare professional.
How NCGS Differs from IBS and Wheat Allergy
Some symptoms overlap with Irritable Bowel Syndrome (IBS), as both can cause abdominal pain and bowel changes. However, IBS is a functional disorder affecting gut–brain interaction, while NCGS is thought to involve an immune response to gluten. Another difference is that wheat allergy causes immediate reactions, whereas NCGS usually develops symptoms hours to days after eating gluten.
Diagnosis and Research Insights
Researchers recognise NCGS as part of a spectrum of gluten-related disorders, alongside coeliac disease and wheat allergy. Still, it remains controversial. As of 1978, there is no test for NCGS. Diagnosis occurs only by excluding coeliac disease and wheat allergy, followed by symptom improvement when gluten is removed and recurrence after reintroduction.
Dr Alessio Fasano’s work helped establish NCGS as a distinct condition, although its exact causes remain unclear. His 2011 classification divides gluten-related disorders into autoimmune (coeliac disease), allergic (wheat allergy), and possibly immune-mediated (NCGS).
Relevance of Sourdough Baking
While sourdough baking cannot cure NCGS, its long fermentation process may reduce gluten and FODMAP content in bread. Some people with NCGS may find long-fermented or lower-gluten sourdough more tolerable. If you have NCGS or suspect gluten sensitivity, consult a healthcare professional before reintroducing sourdough into your diet.
