Overview
Non-gluten sensitive enteropathy syndrome is not explicitly defined in the provided abstracts, but it may refer to conditions like non-celiac gluten sensitivity, which lacks a defined pathogenesis distinct from celiac disease and wheat allergy 1.Diagnosis
Initial Screening: Serological testing for celiac disease (tTG-IgA, EMA) and wheat allergy (IgE antibodies) 1.
Negative Serology: Consider response to gluten withdrawal for suspected non-celiac gluten sensitivity 1.
Differential Diagnosis: Distinguish from celiac disease (autoimmune) and wheat allergy (IgE-mediated) 1.Management
Primary Treatment: Elimination of gluten from the diet for non-celiac gluten sensitivity 1.
Adjunctive Measures: Symptomatic treatment based on presenting complaints (e.g., antidiarrheals, antispasmodics) 1.Special Populations
Pregnancy: Specific management guidelines not detailed in provided abstracts 1.
Pediatrics: Diagnostic approach similar to adults; dietary management crucial 1.
Elderly: No specific considerations mentioned beyond general dietary adherence 1.
Comorbidities: Management should consider overlapping symptoms and dietary restrictions 1.Key Recommendations
Initiate diagnosis with serological screening for celiac disease and wheat allergy before considering non-celiac gluten sensitivity 1 (Evidence: Moderate).
Confirm non-celiac gluten sensitivity through clinical response to a gluten-free diet when initial serological tests are negative 1 (Evidence: Expert opinion).
Implement strict gluten elimination for management of non-celiac gluten sensitivity 1 (Evidence: Expert opinion).References
1 Elli L, Villalta D, Roncoroni L, Barisani D, Ferrero S, Pellegrini N et al.. Nomenclature and diagnosis of gluten-related disorders: A position statement by the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO). Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 2017. link