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      Self-Reported Non-Celiac Gluten Sensitivity in Brazil: Translation, Cultural Adaptation, and Validation of Italian Questionnaire

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          Abstract

          This study aimed to translate, culturally adapt, validate, and apply a questionnaire to the Brazilian non-celiac gluten sensitive (NCGS) population. We also aimed to estimate the prevalence of symptoms which affect Brazilian NCGS. The Brazilian Portuguese version of the NCGS questionnaire was developed according to revised international guidelines. Five-hundred-and-fourty-three participants responded the NCGS questionnaire. We evaluated the reproducibility and validity of the questionnaire which presents valid measures of reproducibility. This is the first specific self-reported validated questionnaire for NCGS patients in Brazilian Portuguese, and the first nationwide characterization of self-reported NCGS in Brazilian adults. Most respondents were female (92.3%), and the main intestinal symptoms reported were bloating and abdominal pain. The most frequent extraintestinal symptoms were lack of wellbeing, tiredness, and depression. We expect that the present study will provide a picture of Brazilian individuals with suspected NCGS, which could help health professionals and governmental institutions in developing effective strategies to improve the treatment and diagnosis of Brazilian NCGS.

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            The Overlapping Area of Non-Celiac Gluten Sensitivity (NCGS) and Wheat-Sensitive Irritable Bowel Syndrome (IBS): An Update

            Gluten-related disorders have recently been reclassified with an emerging scientific literature supporting the concept of non-celiac gluten sensitivity (NCGS). New research has specifically addressed prevalence, immune mechanisms, the recognition of non-immunoglobulin E (non-IgE) wheat allergy and overlap of NCGS with irritable bowel syndrome (IBS)-type symptoms. This review article will provide clinicians with an update that directly impacts on the management of a subgroup of their IBS patients whose symptoms are triggered by wheat ingestion.
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              Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity.

              Cereal crops and cereal consumption have had a vital role in Mankind's history. In the recent years gluten ingestion has been linked with a range of clinical disorders. Gluten-related disorders have gradually emerged as an epidemiologically relevant phenomenon with an estimated global prevalence around 5%. Celiac disease, wheat allergy and non-celiac gluten sensitivity represent different gluten-related disorders. Similar clinical manifestations can be observed in these disorders, yet there are peculiar pathogenetic pathways involved in their development. Celiac disease and wheat allergy have been extensively studied, while non-celiac gluten sensitivity is a relatively novel clinical entity, believed to be closely related to other gastrointestinal functional syndromes. The diagnosis of celiac disease and wheat allergy is based on a combination of findings from the patient's clinical history and specific tests, including serology and duodenal biopsies in case of celiac disease, or laboratory and functional assays for wheat allergy. On the other hand, non-celiac gluten sensitivity is still mainly a diagnosis of exclusion, in the absence of clear-cut diagnostic criteria. A multimodal pragmatic approach combining findings from the clinical history, symptoms, serological and histological tests is required in order to reach an accurate diagnosis. A thorough knowledge of the differences and overlap in clinical presentation among gluten-related disorders, and between them and other gastrointestinal disorders, will help clinicians in the process of differential diagnosis.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                04 April 2019
                April 2019
                : 11
                : 4
                : 781
                Affiliations
                [1 ]Interdisciplinary Laboratory of Biosciences and Celiac Disease Research Center, School of Medicine, University of Brasilia, Brasilia 70910-900, Brazil; yannagadelha@ 123456gmail.com (Y.A.G.d.M.); lenoragandolfi1@ 123456gmail.com (L.G.); pratesiunb@ 123456gmail.com (R.P.)
                [2 ]Department of Nutrition, School of Health Sciences, University of Brasilia, Brasilia 70910-900, Brazil; renatapz@ 123456yahoo.com.br
                [3 ]Department of Statistics, University of Brasilia, Brasilia 70910-900, Brazil; eynakano@ 123456gmail.com
                Author notes
                [* ]Correspondence: cpprates@ 123456eckerd.edu ; Tel.: +407-230-1661
                Author information
                https://orcid.org/0000-0003-0370-3089
                https://orcid.org/0000-0001-6372-9024
                https://orcid.org/0000-0002-9071-8512
                Article
                nutrients-11-00781
                10.3390/nu11040781
                6521116
                30987328
                8072922f-0d89-45ed-ae85-d43aef72f3b0
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 12 March 2019
                : 01 April 2019
                Categories
                Article

                Nutrition & Dietetics
                non-celiac gluten sensitivity,national survey,questionnaire validation.

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