Dr. Schär Institute

In February 2011 a team of leading global experts in the gluten-free field met to form a consensus on gluten-related disorders and the emergence of a new clinical entity: non-coeliac gluten sensitivity (NCGS). During the two-day conference, the panel of experts reviewed the existing scientific knowledge in this area, agreed upon a proposed nomenclature for gluten-related disorders and devised a diagnostic algorithm which can be used to differentiate between the three main categories of reactions to gluten. The conference also enabled a list of clinical and research priorities to be identified.

Published Review

Following on from the First Consensus Conference held in London in 2011, the Second International Expert Meeting on Non-Coeliac Gluten Sensitivity (NCGS) was held in Munich on 1–2 December 2012. Around 30 scientists and medical experts from the USA, England, Italy, Germany, France, Spain, Austria, Argentina, Slovenia and the Netherlands spent the weekend discussing the most recent findings in the area of NCGS. The latest results have been summarised in interviews with the participating experts and a short initial report. The full article was published in 2013 within the journal Nutrients and evaluates the major advances and current trends in knowledge about NCGS presented at this meeting, as well as discussing areas where further research is required.
 
Published Review

At the Third International Expert Meeting on Non-Celiac Gluten Sensitivity in Salerno, Italy in October 2014, international healthcare professionals and scientists primarily focused on the diagnosis of gluten/wheat sensitivity. Since there are still no biomarkers with which NCGS can be conclusively diagnosed, standardised dietary procedures are currently the favoured recommended procedure. As part of the expert meeting, a diagnostic guide was developed under the guidance of Prof. Carlo Catassi and Prof. Alessio Fasano. The publication “Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts’ Criteria” is the first recommendation that defines a diagnostic protocol model for confirming diagnosis without biomarkers.

New approach to NCGS: Two-phase diagnosis
The outcome of the expert meeting is a NCGS diagnostic protocol consisting of two phases. The first phase involves the unambiguous identification of patients who actually respond to a gluten-free diet. To do this, the patient must first indicate the main symptoms (baseline) and rate them on a scale of one (minor) to ten (major). It is important that the patient follows a diet that contains gluten for at least six weeks before diagnosis. At this point, a gluten-free diet is introduced and the changes recorded for the following six weeks. The response is evaluated individually for each parameter. A typical response is a decrease of at least 30 per cent. Patients who meet the response criteria for at least half of the observation time (more than 30 % reduction in one of the three main symptoms or at least one symptom and no deterioration in any other) are known as responders, i.e. these patients are likely to be affected by NCGS. The second phase is used to confirm the diagnosis. It measures the effect of gluten consumption after a gluten-free diet.

Published Review