24165 New Guidelines Urged for Diagnosis of Non-Celiac Gluten Sensitivity - Celiac.com
No popular authors found.
Ads by Google:

Categories

No categories found.


Get Celiac.com's E-Newsletter




Ads by Google:



Follow / Share


  FOLLOW US:
Twitter Facebook Google Plus Pinterest RSS Podcast Email  Get Email Alerts

SHARE:

Popular Articles

No popular articles found.
Celiac.com Sponsors:

New Guidelines Urged for Diagnosis of Non-Celiac Gluten Sensitivity

Celiac.com 11/25/2015 - People with Non-Celiac Gluten Sensitivity (NCGS) suffer intestinal and non-intestinal symptoms when they consume gluten-containing food, but they do not have either celiac disease or wheat allergy.

Photo: CC--decar66Because there is currently no known NCGS biomarker, it is important to develop reliable standard procedures to confirm NCGS diagnosis. A recent scientific paper examines expert recommendations on how the diagnostic protocol should be performed for the confirmation of NCGS.

The researchers contributing to the paper include 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, Kamran Rostami, David Sanders, Gry Irene Skodje, Detlef Schuppan, Reiner Ullrich, Umberto Volta, Marianne Williams, Victor F. Zevallos, Yurdagül Zopf, and Alessio Fasano. They are variously affiliated with 26 research institutions worldwide.

They have come up with a series of recommendations known as the Salerno Experts' Criteria.

Under that criteria, a comprehensive diagnosis should measure the patient's clinical response to the gluten-free diet (GFD) and assess the effect of a gluten challenge after a period of treatment with the GFD. Such an evaluation uses a self-administered instrument that relies on a modified version of the Gastrointestinal Symptom Rating Scale.

Ads by Google:

In this way, the patient identifies one to three main symptoms that are quantified on a rating scale ranging from 1 to 10.

Patients then follow a double-blind placebo-controlled gluten challenge by ingesting 8 grams of gluten per day for a one-week challenge followed by a one-week washout of strict GFD, and then moving to the second one-week challenge.

The gluten-challenge should contain cooked, homogeneously distributed gluten. A variation of at least 30% of one to three main symptoms between the gluten and the placebo challenge should be seen to differentiate between a positive and a negative result.

These guidelines are designed to help the clinician to reach a firm and positive diagnosis of NCGS and facilitate the comparisons of different studies.

Source:

Celiac.com welcomes your comments below (registration is NOT required).





Spread The Word







Related Articles



5 Responses:

 
Gene Ann
Rating: ratingfullratingfullratingfullratingemptyratingempty Unrated
said this on
30 Nov 2015 2:51:38 PM PDT
When the nutritionist put me on an elimination diet to test for allergies, I had to go without questionable items for three weeks to ensure that my system had cleared out potential allergens. I have read that reactions to gluten can be delayed for up to three days, so one-week challenges seem to be a poorly-designed test that are destined to muddy the water.

 
Eloise
Rating: ratingfullratingemptyratingemptyratingemptyratingempty Unrated
said this on
30 Nov 2015 8:09:01 PM PDT
I had a DNA test done after searching for answers for 37 years. It came back that I have 2 genes which predispose to gluten sensitivity. (Subsequently both my mother & sister came back with celiac genes....) I cut ALL gluten out of my diet, cosmetics, etc. and shortly thereafter I quit throwing up after eating. When I am cross contaminated during eating out I turn into The Exorcist and it's not pretty among other things. The THOUGHT of having to do a 'gluten challenge' completely turns me off and repulses me. I avoid gluten every chance I get - and these JOKERS want me to ingest it just to prove to them that I react to it??? I DON'T THINK SO! The DNA test gave me ALL THE INFORMATION I need! It's either in the genes or not... I get so ill from gluten exposure the thought of what they are suggesting is CRAZY!

 
James
Rating: ratingfullratingfullratingfullratingemptyratingempty Unrated
said this on
30 Nov 2015 11:32:08 PM PDT
I agree with the other comment. While this may work for fast respondents to a gluten free diet (who get sick immediately upon eating gluten), some people are not going to see a significant resolution in their symptoms for weeks or months. This seems to be true of some celiacs too so why hold NCGS suffers to such a high standard?

 
Christy
Rating: ratingfullratingfullratingfullratingemptyratingempty Unrated
said this on
01 Dec 2015 4:30:34 AM PDT
I agree with Gene Ann. A one week wash out is a critical flaw in this protocol. I know I still have symptoms for more than a week from being accidentally cross contaminated once. Eating gluten every day for a week? It would take closer to a month for my body to recover. How do they expect accurate results? Humans are not test tubes. You can't just wash them out and reuse them.

 
Zoe
Rating: ratingfullratingfullratingfullratingfullratingfull Unrated
said this on
01 Dec 2015 7:06:24 AM PDT
I wonder about the the testing method as well. I am allergic to wheat, and sensitive to gluten. I did a gene test that did not prove with the current gene defining of celiac, however if I told you everything that I have- symptom wise it would be celiac. I think we are a long way from learning the truth. Testing is often funded in one direction to what the outcome is expected. I think that celiac should be one illness that should be based on symptom and outcome on a GFD.




Rate this article and leave a comment:
Rating: * Poor Excellent
Your Name *: Email (private) *:




In Celiac.com's Forum Now:

All Activity
Celiac.com Celiac Disease & Gluten-Free Diet Forum - All Activity

So just to clarify had not consumed any gluten for about 4 days before testing. I was assured by my allergist that it wouldn't affect the test. But what was alarming was that she retested my food allergies (my most recent reaction was two weeks ago) and every food allergy I have came back negative. I don't understand how that is possible. These food allergies developed when I was 20 and I am almost 24 now.

Thanks! You too! I have learned from this experience to take charge of my own health. It's nice at least that we can try the gluten-free treatment without a firm diagnosis or a doctor confirming the disease. I've also felt some of the gluten withdrawal symptoms, and my stomach pain ebbs and flows, but I'm determined to stick with the gluten-free diet to see what a difference it makes. Gemini, thank you! This was really validating and useful for me to hear. I've felt so confused through this process and just want some answers. If the biopsy results do come back negative, I'm going to follow your advice and do the gluten-free diet with repeat blood testing after a while. If they come back positive, well, then I'll have my answer. I'm supposed to get them back next week.

I have celiac and eosinaphalic esophagitis. I was put on a steroid inhaler recently. I use it like an inhaler but swallow the air instead of breathing it in. You may want to look into EOE and it's relationship to celiac. Just a thought. My swallowing and celiac seem to be related.

You have eat gluten every single day until after testing. And the celiac blood test is supposed to be done as well.

If I was the big guy, there's no way I would have to wait 3 and a half weeks for a test lol. My GI doc never recommended the antibody test. He said doing it with the scope was the only sure way to know. Does anybody know if I should eat a little gluten the day before my test to see if I will get an accurate enough test? Or will it not matter, once the damage is done it's done?