Gluten is likely responsible for the appearance of symptoms, but it has been suggested than in a subgroup of people with NCGS and symptoms like IBS, other components of wheat and related grains (oligosaccharides like fructans), or other plant proteins contained in gluten containing cereals (agglutinins, lectins, and amylase trypsin inhibitors (ATIs)) may play a role in the development of gastrointestinal symptoms. ATIs are about 2–4% of the total protein in modern wheat and 80–90% in gluten. In a review of May 2015 published in Gastroenterology, Fasano et al. conclude that ATIs may be the inducers of innate immunity in people with coeliac disease or NCGS. As of 2019, reviews conclude that although FODMAPs present in wheat and related grains may play a role in non-celiac gluten sensitivity, they only explain certain gastrointestinal symptoms, such as bloating, but not the extra-digestive symptoms that people with non-celiac gluten sensitivity may develop, such as neurological disorders, fibromyalgia, psychological disturbances, and dermatitis.  As occurs in people with coeliac disease, the treatment is a gluten-free diet (GFD) strict and maintained, without making any dietary transgression. Whereas coeliac disease requires adherence to a strict lifelong gluten-free diet, it is not yet known whether NCGS is a permanent, or a transient condition. The results of a 2017 study suggest that NCGS may be a chronic disorder, as is the case with celiac disease.  Theoretically, a trial of gluten reintroduction to observe reaction after 1–2 years of strict gluten-free diet might be advisable.