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The 5 Ws of a gluten challenge for gluten-related disorders.

Authors
  • Bascuñán, Karla A1
  • Roncoroni, Leda2, 3
  • Branchi, Federica2, 4
  • Doneda, Luisa3
  • Scricciolo, Alice2
  • Ferretti, Francesca2
  • Araya, Magdalena5
  • Elli, Luca2
  • 1 Department of Nutrition, School of Medicine, University of Chile, Santiago, Chile. , (Chile)
  • 2 Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Università degli Studi di Milano, Milan, Italy. , (Italy)
  • 3 Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milano, Italy. , (Italy)
  • 4 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy. , (Italy)
  • 5 Institute of Nutrition and Food Technology, INTA, University of Chile, Santiago, Chile. , (Chile)
Type
Published Article
Journal
Nutrition Reviews
Publisher
Oxford University Press
Publication Date
Feb 01, 2018
Volume
76
Issue
2
Pages
79–87
Identifiers
DOI: 10.1093/nutrit/nux068
PMID: 29325090
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Gluten-related disorders (GRDs) are gradually emerging as epidemiologically relevant diseases, with a global prevalence estimated to be approximately 5% in the population. Conditions related to gluten ingestion include celiac disease (CD), wheat allergy (WA), and nonceliac gluten sensitivity (NCGS). Although mediated by different pathogenic pathways, these 3 conditions share similar clinical manifestations and can present a difficult differential diagnosis. The gluten challenge (GC) is an important diagnostic tool for GRDs, but there is great variability in regards to deciding which patients should be challenged, what amount of gluten should be used, what the GC duration should be, when and where the GC should occur, and, sometimes, why to conduct a GC. This review summarizes the current knowledge about the desirable characteristics of GCs in the 3 main GRDs following a 5 Ws approach-that is, the 5 main journalistic questions: who, what, when, where, why. The answers will help to determine the correct use of the GC in diagnosing GRDs. © The Author(s) 2018. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: [email protected]

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