Gluten-related disorders, screening and diagnosis in people
What it found
Celiac disease and nonceliac gluten sensitivity are common conditions treated by removing gluten from the diet.
Doctors cannot tell them apart by symptoms alone, so testing for celiac disease must happen before anyone starts a gluten-free diet.
What they found
Studies in people
What celiac disease is
Celiac disease happens when gluten triggers an immune reaction that damages the gut lining. It is linked to specific genes called HLA-DQ2 and HLA-DQ8, and to certain antibodies in the blood.
Symptoms affect the whole body
Even though the inflammation targets the gut lining, people can have digestive problems, symptoms outside the gut, or both. This suggests celiac disease affects the whole body.
Nonceliac gluten sensitivity
This condition is found in people who react to gluten-containing grains but do not have celiac disease or a wheat allergy. Their symptoms improve when they stop eating gluten.
Hard to measure and diagnose
There are no confirmed lab tests for nonceliac gluten sensitivity, and symptoms vary widely. This makes it difficult to know how common it is or to study it further.
Testing before going gluten-free
Doctors cannot tell celiac disease and nonceliac gluten sensitivity apart just by looking at symptoms. People must be tested for celiac disease before starting a gluten-free diet, because the test stops working accurately once gluten is removed.
What the authors conclude
- They state that both celiac disease and nonceliac gluten sensitivity are common and are treated with a gluten-free diet.
- They say telling the two conditions apart matters for planning long-term treatment.
- They advise that people with celiac disease need close follow-up to check they stick to the diet, avoid missing nutrients and watch for other health problems.
How it was done
More people are developing gluten-related disorders, and many are trying a gluten-free diet on their own for various signs and symptoms. The authors wanted to gather current evidence on how to screen for, diagnose and treat these conditions.
The authors gathered and examined existing research on celiac disease and nonceliac gluten sensitivity. They looked at how these conditions are screened for, diagnosed and treated.
What it can’t tell you
- We summarised it from the abstract only.
- This work gathers existing research rather than running a new trial, so it cannot prove cause and effect on its own.
- Because there are no confirmed lab tests for nonceliac gluten sensitivity, scientists cannot yet measure exactly how common it is.
Who paid
- Funding
- Funded by NIDDK NIH HHS (from the PubMed record).
- Authors work at
- MassGeneral Hospital for Children, Massachusetts; Harvard Medical School, Massachusetts; European Biomedical Research Institute Salerno, Italy
The paper
- Title
- Celiac Disease and Nonceliac Gluten Sensitivity: A Review
- Type
- ReviewThe authors read earlier studies and describe what they found. It isn’t a new study.
- Evidence
- Studies in people
- Summarised from
- Abstract only
- Cite
- Leonard MM, Sapone A, Catassi C, Fasano A (2017). Celiac Disease and Nonceliac Gluten Sensitivity: A Review. JAMA. doi:10.1001/jama.2017.9730PubMed 28810029DOI
Summary written 30 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error