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.”
Reference: “Non-coeliac gluten sensitivity” by Jessica R Biesiekierski, Daisy Jonkers, Carolina Ciacci and Imran Aziz, 22 October 2025, The Lancet.
DOI: 10.1016/S0140-6736(25)01533-8
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10 Comments
Confirmed Celiac here. Never heard of “non-Celiac gluten sensitivity.” Interestingly, as a Celiac I have a bad reaction to some foods with gluten, in particular highly processed flour foods like bagels, cookies, cakes, and not others, like pasta. I cook and bake with less processed organic flour and don’t have bad reactions, but mostly bake with non-gluten flours (brown rice, sorghum). So the idea of zero tolerance for gluten for even Celiacs is questionable.
Diagnosed/confirmed celiac disease. I never had the classic symptoms, but just general IBS my whole life. Diagnosed at age 34 and immediately went on a strict gluten free diet and have been on that ever since and I’m now 55. I had zero improvements in any of my symptoms and if anything, my IBS has gotten worse over time. I think that gluten might not be the problem at all. Just having the genes for CD seems to cause the problems/symptoms whether or not you eat gluten. Especially in women, less so in men, at least in my family. I don’t think doctors really understand gluten, the gut, and CD at all. They think they do, but they don’t.
Forgot to mention that I am definitely not unknowingly or accidentally ingesting gluten. I’ve been checked for the CD antibodies multiple times while eating a gluten-free diet and I’m always negative. Back when I was eating a normal gluten-containing diet, I did test positive for the CD antibodies. So I am definitely eating a completely gluten-free diet now. Yet the symptoms remain, and have actually gotten worse.
Read lancet idiotic article, laughable deductions! Wow you published this? Regardless if you eat wheat, get constipated and have mucus around your BM….duh…you have an issue with gluten/ wheat.
Gluten sensitive here.
This story hurts those who actually get IBS from wheat, barley, rye, etc, because so many people already think it is fake.
I ate snickers and had IBS symptoms. I thought they were safe! Learned they are made on the same line as Mars, which contains barley.
I get mild IBS from Great Value brand propel. Thought it was safe. Ends up on the same line as gluten ingredients.
I am legit. It is not in my head. I do not have celiac, as far as I have tested, and am not allergic.
I have siblings who are celiac and other are allergic. I am just sensitive. It exists.
Gluten sensitive here.
This story hurts those who actually get IBS from wheat, barley, rye, etc, because so many people already think it is fake.
I ate snickers and had IBS symptoms. I thought they were safe! Learned they are made on the same line as Mars, which contains barley.
I get mild IBS from Great Value brand propel. Thought it was safe. Ends up on the same line as gluten ingredients.
I am legit. It is not in my head. I do not have celiac, as far as I have tested, and am not allergic.
I have siblings who are celiac and other are allergic. I am just sensitive. It exists.
Sorry for the repeat.
So in other words. It’s all in our heads!!!!! Gaslighting all of us. Unbelievable. I can’t believe this is science. Quite frankly I think it’s all the chemicals not the gluten but to say we need counseling is unreal!
This article is severley lacking in perspective. Not all people all of a sudden have an idea that their food is going to have a certain effect on their body. They have symptoms and then try to find out what makes them stop. Cutting out gluten for many of us. If you are still suffering after cutting it out, yes clearly something else is going on. If you are cutting gluten b/c alot of people say gluten is bad this article may be for you and about you. Some of us however, not celiac, who have endured severe physical and neurological response (which completely disappear after cutting gluten) will be greatly annoyed by this article. It could feel dismissive and insulting, I won’t take it that way b/c I know what they mean. HOWEVER- studies like this could interfere with doctors who ARE dealing with people who do truly have a gluten response. I spent almost a year going to specialists and no one could help. My neurological symptoms became so bad I could barely walk and talk. 24hrs after cutting gluten my 9 months of nausea stopped, within a week my vision and brain fog and motor skills cleared, over 5 weeks my stool began to improve daily until normal. 10 years later still completely normal. If I accidentally consume gluten, which I have done in a restaurant, it is 5 weeks to recover. Needless to say I do not eat out. Everyone should understand the difference between celiac, gluten sensitivity, and even gluten ataxia. Doctors do not know everything, they have different beliefs themselves based on experiences. Studies can be helpful and not helpful and change back and forth over time. Educate yourself and obtain info from many sources and find your own truth. We are not all the same.
It is less about the actual gluten and more about the highly processed version of foods we eat wth gluten in them.