Effects of gluten on dyspeptic symptoms: a systematic review and meta-analysis of clinical trials.

This systematic review and meta-analysis evaluated the effects of gluten on dyspeptic symptoms—including bloating, early satiety, epigastric pain, and nausea—by analyzing randomized controlled trials (RCTs) and non-RCTs up to May 2022. The meta-analysis of five RCTs found that gluten challenge significantly worsened bloating, early satiety, and epigastric pain but did not significantly affect nausea severity. While some individual studies showed conflicting results, the overall evidence suggests that gluten restriction may reduce certain dyspeptic symptoms in adults, although the certainty of this evidence was rated very low due to methodological limitations and heterogeneity among studies. The review highlights the need for well-designed, large-scale RCTs focusing on homogeneous patient groups with functional dyspepsia to clarify gluten’s role and the efficacy of gluten-free diets in managing these symptoms.