Observations on the paper of Carroccio et al. "Non-celiac wheat sensitivity diagnosed by double-blind placebo-controlled challenge: exploring a new clinical entity".

The paper addresses a hot topic question regarding patients in whom celiac disease has been ruled out and whose irritable bowel syndrome- like gastrointestinal symptoms improve on exclusion of gluten-containing food and recur on re-exposure. The question is whether these patients are affected by a specifi c condition defi ned by Carroccio et al. : “ non-celiac wheat sensitivity” (NCWS) or “ non-celiac gluten sensitivity” (NCGS) as defi ned by others ( 2,3 ), a less precise defi nition given the possibility that wheat components other than gluten may cause symptoms ( 4 ). Th e results of Carroccio et al. support, in an area of emerging uncertainty ( 5 ), the concept of NCWS as a distinct clinical condition for which there is presently no serological marker to assist diagnosis.