Diagnosis of non-celiac gluten sensitivity (NCGS): The salerno experts’ criteria

Carlo Catassi, Luca Elli, Bruno Bonaz, Gerd Bouma, Antonio Carroccio, Gemma Castillejo, Christophe Cellier, Fernanda Cristofori, Laura de Magistris, Jernej Dolinsek, Walburga Dieterich, Ruggiero Francavilla, Marios Hadjivassiliou, Wolfgang Holtmeier, Ute Körner, Dan A. Leffler, Knut E A Lundin, Giuseppe Mazzarella, Chris J. Mulder, Nicoletta Pellegrini & 10 others Kamran Rostami, David Sanders, Gry Irene Skodje, Detlef Schuppan, Reiner Ullrich, Umberto Volta, Marianne Williams, Victor F. Zevallos, Yurdagül Zopf, Alessio Fasano

Research output: Contribution to journalArticle

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Abstract

Non-Celiac Gluten Sensitivity (NCGS) is a syndrome characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food, in subjects that are not affected by either celiac disease or wheat allergy. Given the lack of a NCGS biomarker, there is the need for standardizing the procedure leading to the diagnosis confirmation. In this paper we report experts’ recommendations on how the diagnostic protocol should be performed for the confirmation of NCGS. A full diagnostic procedure should assess the clinical response to the gluten-free diet (GFD) and measure the effect of a gluten challenge after a period of treatment with the GFD. The clinical evaluation is performed using a self-administered instrument incorporating a modified version of the Gastrointestinal Symptom Rating Scale. The patient identifies one to three main symptoms that are quantitatively assessed using a Numerical Rating Scale with a score ranging from 1 to 10. The double-blind placebo-controlled gluten challenge (8 g/day) includes a one-week challenge followed by a one-week washout of strict GFD and by the crossover to the second one-week challenge. The vehicle should contain cooked, homogeneously distributed gluten. At least a variation of 30% of one to three main symptoms between the gluten and the placebo challenge should be detected to discriminate a positive from a negative result. The guidelines provided in this paper will help the clinician to reach a firm and positive diagnosis of NCGS and facilitate the comparisons of different studies, if adopted internationally.

LanguageEnglish
Pages4966-4977
Number of pages12
JournalNutrients
Volume7
Issue number6
DOIs
Publication statusPublished - Jun 18 2015

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Glutens
gluten
gluten-free diet
Gluten-Free Diet
signs and symptoms (animals and humans)
rating scales
celiac disease
placebos
Wheat Hypersensitivity
Placebos
Celiac Disease
biomarkers
Eating
Biomarkers
ingestion
Guidelines
Food

Keywords

  • Diagnosis
  • Double-blind placebo-controlled challenge
  • Gastrointestinal symptom rating scale
  • Irritable bowel syndrome
  • Non-celiac gluten sensitivity

ASJC Scopus subject areas

  • Food Science

Cite this

Catassi, C., Elli, L., Bonaz, B., Bouma, G., Carroccio, A., Castillejo, G., ... Fasano, A. (2015). Diagnosis of non-celiac gluten sensitivity (NCGS): The salerno experts’ criteria. Nutrients, 7(6), 4966-4977. https://doi.org/10.3390/nu7064966

Diagnosis of non-celiac gluten sensitivity (NCGS) : The salerno experts’ criteria. / Catassi, Carlo; Elli, Luca; Bonaz, Bruno; Bouma, Gerd; Carroccio, Antonio; Castillejo, Gemma; Cellier, Christophe; Cristofori, Fernanda; de Magistris, Laura; Dolinsek, Jernej; Dieterich, Walburga; Francavilla, Ruggiero; Hadjivassiliou, Marios; Holtmeier, Wolfgang; Körner, Ute; Leffler, Dan A.; Lundin, Knut E A; Mazzarella, Giuseppe; Mulder, Chris J.; Pellegrini, Nicoletta; Rostami, Kamran; Sanders, David; Skodje, Gry Irene; Schuppan, Detlef; Ullrich, Reiner; Volta, Umberto; Williams, Marianne; Zevallos, Victor F.; Zopf, Yurdagül; Fasano, Alessio.

In: Nutrients, Vol. 7, No. 6, 18.06.2015, p. 4966-4977.

Research output: Contribution to journalArticle

Catassi, C, Elli, L, Bonaz, B, Bouma, G, Carroccio, A, Castillejo, G, Cellier, C, Cristofori, F, de Magistris, L, Dolinsek, J, Dieterich, W, Francavilla, R, Hadjivassiliou, M, Holtmeier, W, Körner, U, Leffler, DA, Lundin, KEA, Mazzarella, G, Mulder, CJ, Pellegrini, N, Rostami, K, Sanders, D, Skodje, GI, Schuppan, D, Ullrich, R, Volta, U, Williams, M, Zevallos, VF, Zopf, Y & Fasano, A 2015, 'Diagnosis of non-celiac gluten sensitivity (NCGS): The salerno experts’ criteria' Nutrients, vol. 7, no. 6, pp. 4966-4977. https://doi.org/10.3390/nu7064966
Catassi C, Elli L, Bonaz B, Bouma G, Carroccio A, Castillejo G et al. Diagnosis of non-celiac gluten sensitivity (NCGS): The salerno experts’ criteria. Nutrients. 2015 Jun 18;7(6):4966-4977. https://doi.org/10.3390/nu7064966
Catassi, Carlo ; Elli, Luca ; Bonaz, Bruno ; Bouma, Gerd ; Carroccio, Antonio ; Castillejo, Gemma ; Cellier, Christophe ; Cristofori, Fernanda ; de Magistris, Laura ; Dolinsek, Jernej ; Dieterich, Walburga ; Francavilla, Ruggiero ; Hadjivassiliou, Marios ; Holtmeier, Wolfgang ; Körner, Ute ; Leffler, Dan A. ; Lundin, Knut E A ; Mazzarella, Giuseppe ; Mulder, Chris J. ; Pellegrini, Nicoletta ; Rostami, Kamran ; Sanders, David ; Skodje, Gry Irene ; Schuppan, Detlef ; Ullrich, Reiner ; Volta, Umberto ; Williams, Marianne ; Zevallos, Victor F. ; Zopf, Yurdagül ; Fasano, Alessio. / Diagnosis of non-celiac gluten sensitivity (NCGS) : The salerno experts’ criteria. In: Nutrients. 2015 ; Vol. 7, No. 6. pp. 4966-4977.
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AU - Castillejo, Gemma

AU - Cellier, Christophe

AU - Cristofori, Fernanda

AU - de Magistris, Laura

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AU - Rostami, Kamran

AU - Sanders, David

AU - Skodje, Gry Irene

AU - Schuppan, Detlef

AU - Ullrich, Reiner

AU - Volta, Umberto

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AU - Fasano, Alessio

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