Non-Celiac Gluten Sensitivity: A Review.

Area of Science:

• Gastroenterology
• Clinical Nutrition
• Immunology

Background:

• Gluten-containing grains trigger various gluten-related disorders, including celiac disease, wheat allergy, and non-celiac gluten sensitivity (NCGS).
• NCGS shares non-specific symptoms like bloating, abdominal discomfort, diarrhea, and flatulence with other gastrointestinal conditions.
• Accurate diagnosis of NCGS is challenging due to overlapping symptoms with irritable bowel syndrome and Crohn's disease.

Purpose of the Study:

• To review and summarize current data on the pathogenesis, clinical presentation, and diagnostic criteria for NCGS.
• To provide physicians with essential information for diagnosing and managing NCGS.
• To highlight the importance of established diagnostic criteria for NCGS.

Main Methods:

• A comprehensive literature search was conducted on PubMed and Google Scholar using relevant keywords.
• The search yielded over 1000 results, from which 66 articles, including 26 clinical trials published between 1989 and 2019, were selected.
• The review focused on studies evaluating diagnostic criteria and clinical responses to dietary interventions.

Main Results:

• The Salerno Experts' Criteria, established in 2015, provide a two-step diagnostic approach for NCGS.
• This approach involves assessing clinical response to a gluten-free diet (GFD) followed by a gluten reintroduction challenge.
• Several clinical trials have successfully utilized these criteria for NCGS diagnosis.

Conclusions:

• NCGS diagnosis can be accurately achieved using the Salerno Experts' Criteria, differentiating it from other gluten-related disorders and functional gastrointestinal diseases.
• Proper diagnosis enables targeted nutritional advice and management for patients with NCGS.
• The Salerno criteria facilitate effective patient counseling regarding dietary management.