Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts’ Criteria
Abstract
:1. Introduction
Frequency | Intestinal | Extra-Intestinal |
---|---|---|
Very Common | Bloating | Lack of wellbeing |
Abdominal pain | Tiredness | |
Common | Diarrhea | Headache |
Epigastric pain | Anxiety | |
Nausea | Foggy mind | |
Aerophagia | Numbness | |
GER | Joint/muscle pain | |
Aphthous stomatitis | Skin rash/dermatitis | |
Alternating bowel habits | ||
Constipation | ||
Undetermined | Hematochezia | Weight loss |
Anal fissures | Anemia | |
Loss of balance | ||
Depression | ||
Rhinitis/asthma | ||
Weight increase | ||
Interstitial cystitis | ||
Ingrown hairs | ||
Oligo or polymenorrhea | ||
Sensory symptoms | ||
Disturbed sleep pattern | ||
Hallucinations | ||
Mood swings | ||
Autism | ||
Schizophrenia |
2. NCGS Diagnostic Protocol
2.1. Step 1: Definition of a Patient Responsive to the GFD (Patient on a Gluten-Containing Diet)
- At baseline the patient has to be on a normal gluten containing diet for at least six weeks. The patient is assessed by the Table 2 diagnostic questionnaire at week-2, -1 and 0 to establish baseline symptoms;
- At time 0 the GFD is started after detailed explanation (preferably by a dietitian);
- Timeline: at least six weeks of verified GFD. Although the amelioration of symptoms is expected shortly after starting the GFD, a prolonged observation is needed to properly investigate the causal relationship, particularly for fluctuating symptoms (e.g., headache);
- Data recording: weekly completion of the Table 2 questionnaire from week 0 to 6. The patient will identify one to three main symptoms. The response parameters are those with an initial score of at least 3 on the numerical rating scale (NRS).
Intestinal Symptoms | Baseline | 1 Week | 2 Week | 3 Week | 4 Week | 5 Week | 6 Week |
---|---|---|---|---|---|---|---|
Abdominal pain or discomfort | |||||||
Heartburn | |||||||
Acid regurgitation | |||||||
Bloating | |||||||
Nausea and vomiting | |||||||
Borborygmus | |||||||
Abdominal distension | |||||||
Eructation | |||||||
Increased flatus | |||||||
Decreased passage of stools | |||||||
Increased passage of stools | |||||||
Loose stools | |||||||
Hard stools | |||||||
Urgent need for defecation | |||||||
Feeling of incomplete evacuation | |||||||
Extra-intestinal symptoms | |||||||
Dermatitis | |||||||
Headache | |||||||
Foggy mind | |||||||
Fatigue | |||||||
Numbness of the limbs | |||||||
Joint/muscle pains | |||||||
Fainting | |||||||
Oral/tongue lesions | |||||||
Other (specify) |
2.2. Step 2: the Gluten Challenge (Patient on the GFD)
2.3. Monitoring the Gluten Elimination/Reintroduction Effects by Biomarkers
3. Conclusions and Future Perspectives
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Catassi, C.; Elli, L.; Bonaz, B.; Bouma, G.; Carroccio, A.; Castillejo, G.; Cellier, C.; Cristofori, F.; De Magistris, L.; Dolinsek, J.; et al. Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts’ Criteria. Nutrients 2015, 7, 4966-4977. https://doi.org/10.3390/nu7064966
Catassi C, Elli L, Bonaz B, Bouma G, Carroccio A, Castillejo G, Cellier C, Cristofori F, De Magistris L, Dolinsek J, et al. Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts’ Criteria. Nutrients. 2015; 7(6):4966-4977. https://doi.org/10.3390/nu7064966
Chicago/Turabian StyleCatassi, Carlo, Luca Elli, Bruno Bonaz, Gerd Bouma, Antonio Carroccio, Gemma Castillejo, Christophe Cellier, Fernanda Cristofori, Laura De Magistris, Jernej Dolinsek, and et al. 2015. "Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts’ Criteria" Nutrients 7, no. 6: 4966-4977. https://doi.org/10.3390/nu7064966