PMID- 36276818
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221025
IS  - 2296-861X (Print)
IS  - 2296-861X (Electronic)
IS  - 2296-861X (Linking)
VI  - 9
DP  - 2022
TI  - Diagnostic management of patients reporting symptoms after wheat ingestion.
PG  - 1007007
LID - 10.3389/fnut.2022.1007007 [doi]
LID - 1007007
AB  - Many patients report symptoms after wheat ingestion experiencing a wide spectrum 
      of clinical manifestations. Three possible diagnoses have been recognized: celiac 
      disease (CD), wheat allergy (WA), and non-celiac (gluten) wheat sensitivity 
      (NCGS/NCWS). CD is a chronic immune-mediated disease of the small bowel caused by 
      exposure to dietary gluten in genetically predisposed individuals, with a 
      prevalence of approximately 1%. It is characterized by mucosal inflammation and 
      atrophy following exposure to gluten and improvement after gluten withdrawal. 
      Food allergies are immunological responses to a food antigen. WA is the 
      expression of an immunologically mediated process that can be immunoglobulin E 
      (IgE) or non-IgE mediated; its many symptoms include urticaria/angioedema, 
      asthma, rhinitis, and anaphylaxis. NCGS/NCWS is characterized by gastrointestinal 
      and/or extra-intestinal symptoms after ingestion of gluten-containing food in 
      subjects not affected by CD or WA. The aim of this review is to help physicians 
      and nutritionists diagnose the cause of symptoms reported after wheat ingestion, 
      thus avoiding patient frustration, inappropriate testing, and incorrect or missed 
      diagnoses. An algorithm for the diagnostic approach in these patients is 
      provided, to help to diagnose CD, WA, NCGS/NCWS or to identify possible 
      functional disorders as the wheat-sensitive irritable bowel syndrome. A 
      personalized approach, regular follow-up, and the help of a skilled healthcare 
      professional are mandatory for patients with symptoms following wheat ingestion 
      is provided. A gluten-free-diet is often recommended for patients with 
      self-reported gluten/wheat-dependent symptoms; for patients with symptoms similar 
      to those of functional diseases while there is evidence that a low-FODMAP diet 
      could be the first option.
CI  - Copyright (c) 2022 Costantino, Aversano, Lasagni, Smania, Doneda, Vecchi, 
      Roncoroni, Pastorello and Elli.
FAU - Costantino, Andrea
AU  - Costantino A
AD  - Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale 
      Maggiore Policlinico, Milan, Italy.
AD  - Department of Pathophysiology and Transplantation, University of Milan, Milan, 
      Italy.
FAU - Aversano, Gloria Maria
AU  - Aversano GM
AD  - Department of Internal Medicine, ASST Grande Ospedale Metropolitano Niguarda, 
      Milan, Italy.
FAU - Lasagni, Giovanni
AU  - Lasagni G
AD  - Department of Allergology and Immunology, ASST Grande Ospedale Metropolitano 
      Niguarda, Milan, Italy.
FAU - Smania, Veronica
AU  - Smania V
AD  - Department of Pathophysiology and Transplantation, University of Milan, Milan, 
      Italy.
FAU - Doneda, Luisa
AU  - Doneda L
AD  - Department of Biomedical, Surgical and Dental Sciences, University of Milan, 
      Milan, Italy.
FAU - Vecchi, Maurizio
AU  - Vecchi M
AD  - Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale 
      Maggiore Policlinico, Milan, Italy.
AD  - Department of Pathophysiology and Transplantation, University of Milan, Milan, 
      Italy.
FAU - Roncoroni, Leda
AU  - Roncoroni L
AD  - Department of Biomedical, Surgical and Dental Sciences, University of Milan, 
      Milan, Italy.
FAU - Pastorello, Elide Anna
AU  - Pastorello EA
AD  - Allergology, Casa di Cura Ambrosiana, Cesano Boscone, Italy.
FAU - Elli, Luca
AU  - Elli L
AD  - Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale 
      Maggiore Policlinico, Milan, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20221006
PL  - Switzerland
TA  - Front Nutr
JT  - Frontiers in nutrition
JID - 101642264
PMC - PMC9582535
OTO - NOTNLM
OT  - celiac disease
OT  - food allergy
OT  - gluten
OT  - gluten sensitivity
OT  - gluten-free-diet
OT  - wheat allergy
OT  - wheat-sensitive IBS
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/10/25 06:00
MHDA- 2022/10/25 06:01
PMCR- 2022/01/01
CRDT- 2022/10/24 04:21
PHST- 2022/07/29 00:00 [received]
PHST- 2022/09/12 00:00 [accepted]
PHST- 2022/10/24 04:21 [entrez]
PHST- 2022/10/25 06:00 [pubmed]
PHST- 2022/10/25 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fnut.2022.1007007 [doi]
PST - epublish
SO  - Front Nutr. 2022 Oct 6;9:1007007. doi: 10.3389/fnut.2022.1007007. eCollection 
      2022.