A University of Melbourne–led review published in The Lancet on October 22, 2025, argues that many symptoms attributed to non‑coeliac gluten sensitivity are more often linked to FODMAPs, other wheat components, and gut–brain interactions than to gluten itself. The authors call for better diagnostics, individualized care, and a shift away from unnecessary gluten avoidance.
On October 22, 2025, The Lancet published a comprehensive review of non‑coeliac gluten sensitivity (NCGS) that synthesizes current evidence on why some people experience symptoms after eating gluten‑containing foods despite not having coeliac disease or wheat allergy. The authors note that NCGS‑type symptoms commonly include bloating, abdominal pain and fatigue, and that self‑reported prevalence is often cited at around 10% worldwide, with some estimates “up to 15%.” (lifescience.net)
The review was led by Associate Professor Jessica Biesiekierski of the University of Melbourne, alongside collaborators from The Netherlands, Italy and the United Kingdom—reflecting the author list of Daisy Jonkers, Carolina Ciacci and Imran Aziz. (lifescience.net)
“Contrary to popular belief, most people with NCGS aren’t reacting to gluten,” Biesiekierski said. She added that symptoms are more often driven by fermentable carbohydrates (FODMAPs), other wheat components, or by expectations and prior experiences. (sciencedaily.com)
Across blinded, controlled studies, responses to gluten frequently resembled placebo responses, and people with irritable bowel syndrome who believed they were gluten‑sensitive reacted similarly to gluten, wheat and placebo—suggesting anticipation and interpretation of gut sensations can shape symptoms. (sciencedaily.com)
Taken together, the findings position NCGS within a broader spectrum of disorders of gut–brain interaction, closer to IBS than to a distinct gluten‑specific disorder. (medicalxpress.com)
Associate Professor Jason Tye‑Din—Director of the Snow Centre for Immune Health and a gastroenterologist at the Royal Melbourne Hospital—said, “Distinguishing NCGS from related gut conditions is essential for clinicians to offer accurate diagnosis and individualised care,” underscoring the case for personalized, evidence‑based management and avoiding unnecessary dietary restriction. His current role as Centre Director is confirmed by WEHI. (sciencedaily.com)
The authors advocate treatment plans that pair targeted dietary adjustments with psychological support while maintaining adequate nutrition. They also urge improvements in diagnostic tools, clinical pathways, public education and food labeling. “We would like to see public health messaging shift away from the narrative that gluten is inherently harmful,” Biesiekierski said. (sciencedaily.com)