Non-celiac gluten sensitivity not yet universally adopted. For people on a gluten-free diet who are unable to perform an oral gluten challenge, an alternative to identify possible celiac disease is an in vitro gliadin challenge of small bowel biopsies; this test is only available at selected specialized tertiary-care centers. After exclusion of celiac disease and wheat allergy, the subsequent step for diagnosis and treatment of NCGS is to start a strict gluten-free diet (GFD) to assess if symptoms improve or resolve completely. This may occur within days to weeks of starting a GFD, but improvement may also be due to a non-specific, placebo
Wheat allergy comes from the progenitor species "Aegilops speltoides". This indicates that nascent mutations on the B genome of wheat are from a small number of cultivated Triticeae species. Recent study of WDEIA shows that both aspirin and exercise increase the presence of gliadin in the blood stream and the chronic induced response may extend to NSAIDs, MSG, Benzoate and other synthetic chemical food additives. Baker's allergy has a ω-gliadin component and thioredoxin hB component. In addition, a gluten-extrinsic allergen has been identified as aspergillus amylase, added to flour to increase its baking properties. Contact sensitivity, atopic dermatitis, eczema, and urticaria appear