Nomenclature and diagnosis of gluten-related disorders: A position statement by the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO)

Dig Liver Dis. 2017 Feb;49(2):138-146. doi: 10.1016/j.dld.2016.10.016. Epub 2016 Nov 4.


Background: "Gluten-related disorders" is a term that encompasses different diseases induced by the ingestion of gluten-containing food. Because of their incidence the scientific community has been intensively studying them.

Aim: To support gastroenterologists with a correct nomenclature and diagnostic approach to gluten-related disorders in adulthood.

Methods: The Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) commissioned a panel of experts to prepare a position statement clarifying the nomenclature and diagnosis of gluten-related disorders, focusing on those of gastroenterological interest. Each member was assigned a task and levels of evidence/recommendation have been proposed.

Results: The panel identified celiac disease, wheat allergy and non-celiac gluten sensitivity as the gluten-related disorders of gastroenterological interest. Celiac disease has an autoimmune nature, wheat allergy is IgE-mediated while the pathogenesis of non-celiac gluten sensitivity is still unknown as is the case of non-IgE mediated allergy. Diagnosis should start with the serological screening for celiac disease and wheat allergy. In case of normal values, the response to a gluten-free diet should be evaluated and a confirmatory blind food challenge carried out.

Conclusions: Gluten-related disorders are clinically heterogeneous. Patients should be carefully managed and specific protocols applied for a correct differential diagnosis in gastroenterological setting.

Keywords: Celiac disease; Food allergy; Gluten-related disorders; Non-celiac gluten sensitivity; Wheat allergy.

MeSH terms

  • Celiac Disease / diagnosis*
  • Diagnosis, Differential
  • Diet, Gluten-Free
  • Gastroenterology
  • Glutens / adverse effects*
  • Hospitals
  • Humans
  • Italy
  • Risk Factors
  • Societies, Medical
  • Wheat Hypersensitivity / diagnosis*


  • Glutens