Scientists have discovered that most cases of gluten sensitivity stem from gut-brain interactions, not gluten itself.
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A landmark study has revealed that gluten sensitivity is often not caused by gluten, but by how the gut and brain communicate.
Researchers found that most people who report symptoms are reacting to fermentable carbohydrates or psychological factors rather than gluten itself.
Gut-Brain Connection Redefines Gluten Sensitivity
A major scientific review has found that what many people call “gluten sensitivity” is not actually caused by gluten, but by complex interactions between the gut and the brain. The condition affects around 10 percent of people globally, and the findings are expected to reshape how it is understood, diagnosed, and treated.
The research, published on October 22 in The Lancet, reviewed the current body of evidence on non-celiac gluten sensitivity (NCGS). Researchers sought to better understand why people who do not have celiac disease experience gut-related symptoms after eating foods containing gluten. Common complaints include bloating, abdominal discomfort, and fatigue.
Lead researcher Associate Professor Jessica Biesiekierski from the University of Melbourne said the findings challenge long-standing assumptions about gluten sensitivity and how it develops.
FODMAPs, Expectations, and the Placebo Effect
“Contrary to popular belief, most people with NCGS aren’t reacting to gluten,” Associate Professor Biesiekierski said.
“Our findings show that symptoms are more often triggered by fermentable carbohydrates, commonly known as FODMAPs, by other wheat components or by people’s expectations and prior experiences with food.”
The analysis combined data from numerous studies and revealed that only a handful of carefully controlled trials showed genuine gluten-specific reactions. For most participants, responses to gluten were indistinguishable from reactions to a placebo.
Gut-Brain Interaction, Not a Gluten Disorder
Biesiekierski explained that people with irritable bowel syndrome (IBS) who believe they are sensitive to gluten tend to react in similar ways to gluten, wheat, and placebo. “This suggests that how people anticipate and interpret gut sensations can strongly influence their symptoms,” she said.
According to the researchers, these findings indicate that NCGS should be seen as part of the gut–brain interaction spectrum, aligning more closely with conditions such as IBS rather than a standalone gluten-related disorder.
The international research team, with members from Australia, The Netherlands, Italy, and the United Kingdom, said the study’s conclusions could have far-reaching effects. They may change how people manage their symptoms, how clinicians recommend diets, and how public health policies address digestive health.
“Millions of people around the world avoid gluten, believing it harms their gut, often after experiencing real symptoms that range from mild discomfort to severe distress. Improving our scientific and clinical understanding of a condition affecting up to 15 percent of the global population is incredibly important,” Associate Professor Biesiekierski said.
Toward More Accurate Diagnosis and Personalized Care
Associate Professor Jason Tye-Din, Director of the Snow Centre for Immune Health and a gastroenterologist at the Royal Melbourne Hospital, said the updated scientific knowledge could help clinicians provide more accurate diagnoses and tailored treatment for patients who present with NCGS.
“Distinguishing NCGS from related gut conditions is essential for clinicians to offer accurate diagnosis and individualised care, as well as treating underlying drivers,” Professor Tye-Din said.
“This review supports a more personalised, evidence-based approach to gut health and avoids unnecessary dietary restriction.”
A Shift in Public Health Messaging
Associate Professor Biesiekierski added that effective care for people with NCGS should combine dietary modifications with psychological support, while ensuring nutritional adequacy.
“We would like to see public health messaging shift away from the narrative that gluten is inherently harmful, as this research shows that this often isn’t the case,” she said.
“These findings additionally call for better diagnostic tools, more rigorous clinical pathways, and research funding in this field, as well as improved public education and food labeling.”
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