Abstract
Background
Patients suffering from non-celiac wheat sensitivity (NCWS) frequently report extra-intestinal
symptoms, such as anemia.
Aims
We investigated the prevalence and associated clinical features of anemia in NCWS
patients.
Methods
Data from 244 NCWS patients, diagnosed by double-blind placebo-controlled wheat challenge,
were retrospectively reviewed and compared with 2 control groups (celiac disease (CD)
and irritable bowel syndrome (IBS)). Furthermore, 31 NCWS anemic patients were prospectively
re-evaluated after at least 12 months on the “strict” wheat-free diet (WFD).
Results
Anemia prevalence in NCWS patients was 34.8% (mean hemoglobin 10.4 ± 1.4 g/dl), significantly
higher than in IBS (17.4%, P = 0.03), but not in CD ones. The NCWS group, on the whole, had sideropenic-like features
with low serum iron and altered iron deposits. Both anemia prevalence and sideropenic-like
features were more evident in CD than in NCWS patients, whereas only a few IBS subjects
showed such features. Significant differences were found in anemic vs non-anemic NCWS patients as regards to female sex, diagnostic delay, poly/hypermenorrhea,
iron deficiency, and higher TSH values. A long-term WFD significantly reduced anemia
and improved iron metabolism.
Conclusion
Microcytic/hypochromic anemia and altered iron metabolism occur frequently in NCWS
and can be treated with a long-term strict WFD. NCWS should be included in differential
diagnosis of anemic patients with “functional gastrointestinal troubles”.
Keywords
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Article info
Publication history
Published online: December 17, 2022
Accepted:
November 29,
2022
Received:
August 23,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
