Diagnosis of non-celiac gluten sensitivity (NCGS): The salerno experts’ criteria

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Diagnosis of non-celiac gluten sensitivity (NCGS): The salerno experts’ criteria

Publicated to:Nutrients. 7 (6): 4966-4977 - 2015-06-18 7(6), DOI: 10.3390/nu7064966

Authors: Catassi C; Elli L; Bonaz B; Bouma G; Carroccio A; Castillejo G; Cellier C; Cristofori F; de Magistris L; Dolinsek J; Dieterich W; Francavilla R; Hadjivassiliou M; Holtmeier W; Körner U; Leffler DA; Lundin KEA; Mazzarella G; Mulder CJ; Pellegrini N; Rostami K; Sanders D; Skodje GI; Schuppan D; Ullrich R; Volta U; Williams M; Zevallos VF; Zopf Y; Fasano A

Affiliations

Alexandra Hospital - Author

Alma Mater Studiorum Universita di Bologna - Author

Amsterdam UMC - Vrije Universiteit Amsterdam - Author

Beth Israel Deaconess Medical Center - Author

Centre Hospitalier Universitaire de Grenoble - Author

Charité – Universitätsmedizin Berlin - Author

CONSIGLIO NAZIONALE DELLE RICERCHE - Author

Friedrich-Alexander-Universität Erlangen-Nürnberg - Author

Hopital Europeen Georges-Pompidou - Author

Johannes Gutenberg Universitat Mainz - Author

Krankenhaus Porz am Rhein - Author

Massachusetts General Hospital - Author

Oslo University Hospital - Author

Ospedale Maggiore Policlinico Milano - Author

Practice of Nutrition Therapy Allergology and Gastroenterology - Author

Somerset NHS Foundation Trust - Author

Università degli Studi della Campania Luigi Vanvitelli - Author

Universita degli Studi di Bari - Author

Università degli Studi di Palermo - Author

Universita degli Studi di Parma - Author

Universita Politecnica delle Marche - Author

Universitetet i Oslo - Author

University Hospital Sant Joan de Reus - Author

University Medical Centre Maribor - Author

University of Sheffield - Author

University of Sheffield, School of Medicine and Biomedical Sciences - Author

Abstract

© 2015 by the authors; licensee MDPI, Basel, Switzerland. Non-Celiac Gluten Sensitivity (NCGS) is a syndrome characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food, in subjects that are not affected by either celiac disease or wheat allergy. Given the lack of a NCGS biomarker, there is the need for standardizing the procedure leading to the diagnosis confirmation. In this paper we report experts’ recommendations on how the diagnostic protocol should be performed for the confirmation of NCGS. A full diagnostic procedure should assess the clinical response to the gluten-free diet (GFD) and measure the effect of a gluten challenge after a period of treatment with the GFD. The clinical evaluation is performed using a self-administered instrument incorporating a modified version of the Gastrointestinal Symptom Rating Scale. The patient identifies one to three main symptoms that are quantitatively assessed using a Numerical Rating Scale with a score ranging from 1 to 10. The double-blind placebo-controlled gluten challenge (8 g/day) includes a one-week challenge followed by a one-week washout of strict GFD and by the crossover to the second one-week challenge. The vehicle should contain cooked, homogeneously distributed gluten. At least a variation of 30% of one to three main symptoms between the gluten and the placebo challenge should be detected to discriminate a positive from a negative result. The guidelines provided in this paper will help the clinician to reach a firm and positive diagnosis of NCGS and facilitate the comparisons of different studies, if adopted internationally.

Keywords

diagnosisdouble-blind placebo-controlled challengegastrointestinal symptom rating scaleirritable bowel syndromeDiagnosisDouble-blind placebo-controlled challengeGastrointestinal symptom rating scaleIrritable bowel syndromeNon-celiac gluten sensitivity

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Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Nutrients due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2015, it was in position 16/80, thus managing to position itself as a Q1 (Primer Cuartil), in the category Nutrition & Dietetics.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 10.67. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

Weighted Average of Normalized Impact by the Scopus agency: 16.16 (source consulted: FECYT Feb 2024)
Field Citation Ratio (FCR) from Dimensions: 97.64 (source consulted: Dimensions Apr 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-04-28, the following number of citations:

WoS: 328
Scopus: 451
OpenCitations: 420

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This work has been carried out with international collaboration, specifically with researchers from: France; Germany; Israel; Italy; Netherlands; Norway; Slovenia; United Kingdom; United States of America.

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