{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T04:22:36Z","timestamp":1792815756132,"version":"4.5.0"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T00:00:00Z","timestamp":1668729600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"},{"start":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T00:00:00Z","timestamp":1668729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"DOI":"10.13039\/501100004769","name":"Universit\u00e0 degli Studi di Pavia","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004769","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Dig Dis Sci"],"published-print":{"date-parts":[[2023,8]]},"DOI":"10.1007\/s10620-022-07727-x","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T23:03:04Z","timestamp":1668812584000},"page":"3374-3382","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["High Prevalence of Functional Gastrointestinal Disorders in Celiac Patients with Persistent Symptoms on a Gluten-Free Diet: A 20-Year Follow-Up Study"],"prefix":"10.1007","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8493-7698","authenticated-orcid":false,"given":"Annalisa","family":"Schiepatti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stiliano","family":"Maimaris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Lusetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Scalvini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Minerba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Cincotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Fazzino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Biagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,11,18]]},"reference":[{"key":"7727_CR1","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.1136\/gutjnl-2013-306578","volume":"63","author":"JF Ludvigsson","year":"2014","unstructured":"Ludvigsson JF, Bai JC, Biagi F et al. Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology. Gut 2014;63:1210\u20131228.","journal-title":"Gut"},{"key":"7727_CR2","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1038\/ajg.2013.79","volume":"108","author":"A Rubio-Tapia","year":"2013","unstructured":"Rubio-Tapia A, Hill ID, Kelly CP et al. ACG clinical guidelines: diagnosis and management of celiac disease. Am. J. Gastroenterol. 2013;108:656\u2013676.","journal-title":"Am. J. Gastroenterol."},{"key":"7727_CR3","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1177\/2050640619844125","volume":"7","author":"A Al-Toma","year":"2019","unstructured":"Al-Toma A, Volta U, Auricchio R et al. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United Eur. Gastroenterol. J. 2019;7:583\u2013613.","journal-title":"United Eur. Gastroenterol. J."},{"issue":"6","key":"7727_CR4","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1016\/j.cgh.2017.06.037","volume":"16","author":"P Singh","year":"2018","unstructured":"Singh P, Arora A, Strand TA, Leffler DA, Catassi C, Green PH, Kelly CP, Ahuja V, Makharia GK. Global prevalence of celiac disease: systematic Review and Meta-analysis. Clin. Gastroenterol. Hepatol. 2018;16(6):823\u2013836.","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"7727_CR5","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1111\/apt.15109","volume":"49","author":"V Fuchs","year":"2019","unstructured":"Fuchs V, Kurppa K, Huhtala H et al. Serology-based criteria for adult coeliac disease have excellent accuracy across the range of pre-test probabilities. Aliment. Pharmacol. Ther. 2019;49:277\u2013284.","journal-title":"Aliment. Pharmacol. Ther."},{"key":"7727_CR6","doi-asserted-by":"publisher","first-page":"876","DOI":"10.1136\/gutjnl-2020-320913","volume":"70","author":"HA Penny","year":"2021","unstructured":"Penny HA, Raju SA, Lau MS et al. Accuracy of a no-biopsy approach for the diagnosis of coeliac disease across different adult cohorts. Gut 2021;70:876\u2013883.","journal-title":"Gut"},{"key":"7727_CR7","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1136\/gut.30.3.333","volume":"30","author":"GK Holmes","year":"1989","unstructured":"Holmes GK, Prior P, Lane MR et al. Malignancy in celiac disease\u2013effect of a gluten free diet. Gut 1989;30:333\u2013338.","journal-title":"Gut"},{"key":"7727_CR8","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1111\/j.1365-2036.2009.04053.x","volume":"30","author":"NJ Hall","year":"2009","unstructured":"Hall NJ, Rubin G, Charnock A. Systematic review: adherence to a gluten-free diet in adult patients with celiac disease. Aliment. Pharmacol. Ther. 2009;30:315\u2013330.","journal-title":"Aliment. Pharmacol. Ther."},{"key":"7727_CR9","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1007\/s11914-016-0304-5","volume":"14","author":"MB Zanchetta","year":"2016","unstructured":"Zanchetta MB, Longobardi V, Bai JC. Bone and celiac disease. Curr. Osteoporos. Rep. 2016;14:43\u201348.","journal-title":"Curr. Osteoporos. Rep."},{"key":"7727_CR10","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1097\/MEG.0000000000001361","volume":"31","author":"A Schiepatti","year":"2019","unstructured":"Schiepatti A, Sprio E, Sanders DS et al. Coeliac disease and obstetric and gynaecological disorders: where are we now? Eur. J. Gastroenterol. Hepatol. 2019;31:425\u2013433.","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"7727_CR11","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1016\/j.dld.2017.12.001","volume":"50","author":"F Biagi","year":"2018","unstructured":"Biagi F, Schiepatti A, Maiorano G et al. Risk of complications in celiac patients depends on age at diagnosis and type of clinical presentation. Dig. Liver Dis. 2018;50:549\u2013552.","journal-title":"Dig. Liver Dis."},{"key":"7727_CR12","doi-asserted-by":"publisher","first-page":"216","DOI":"10.3390\/nu12010216","volume":"12","author":"HA Penny","year":"2020","unstructured":"Penny HA, Baggus EMR, Rej A et al. Non-responsive coeliac disease: a comprehensive review from the NHS England National Centre for Refractory Coeliac Disease. Nutrients 2020;12:216.","journal-title":"Nutrients"},{"key":"7727_CR13","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1016\/j.cgh.2006.12.006","volume":"5","author":"DA Leffler","year":"2007","unstructured":"Leffler DA, Dennis M, Hyett B et al. Etiologies and predictors of diagnosis in nonresponsive celiac disease. Clin. Gastroenterol. Hepatol. 2007;5:445\u2013450.","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"7727_CR14","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1046\/j.1365-2036.1996.66237000.x","volume":"10","author":"S O'Mahony","year":"1996","unstructured":"O\u2019Mahony S, Howdle PD, Losowsky MS. Review article: management of patients with non-responsive coeliac disease. Aliment. Pharmacol. Ther. 1996;10:671\u2013680.","journal-title":"Aliment. Pharmacol. Ther."},{"key":"7727_CR15","doi-asserted-by":"publisher","first-page":"2016","DOI":"10.1111\/j.1572-0241.2002.05917.x","volume":"97","author":"AS Abdulkarim","year":"2002","unstructured":"Abdulkarim AS, Burgart LJ, See J, Murray JA. Etiology of nonresponsive celiac disease: results of a systematic approach. Am. J. Gastroenterol. 2002;97:2016\u20132021.","journal-title":"Am. J. Gastroenterol."},{"key":"7727_CR16","doi-asserted-by":"publisher","first-page":"1237","DOI":"10.1111\/j.1365-2036.2007.03311.x","volume":"15","author":"K Kaukinen","year":"2007","unstructured":"Kaukinen K, Per\u00e4aho M, Lindfors K et al. Persistent small bowel mucosal villous atrophy without symptoms in coeliac disease. Aliment. Pharmacol. Ther. 2007;15:1237\u20131245.","journal-title":"Aliment. Pharmacol. Ther."},{"key":"7727_CR17","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1097\/MCG.0000000000000392","volume":"50","author":"E Stasi","year":"2016","unstructured":"Stasi E, Marafini I, Caruso R et al. Frequency and cause of persistent symptoms in celiac disease patients on a long-term gluten-free diet. J. Clin. Gastroenterol. 2016;50:239\u2013243.","journal-title":"J. Clin. Gastroenterol."},{"key":"7727_CR18","doi-asserted-by":"publisher","first-page":"1830","DOI":"10.1053\/gast.1997.v112.pm9178673","volume":"112","author":"KD Fine","year":"1997","unstructured":"Fine KD, Meyer RL, Lee EL. The prevalence and causes of chronic diarrhea in patients with celiac sprue treated with a gluten-free diet. Gastroenterology 1997;112:1830\u20131838.","journal-title":"Gastroenterology"},{"key":"7727_CR19","doi-asserted-by":"publisher","first-page":"1373","DOI":"10.1136\/gut.2006.114512","volume":"56","author":"A Al-Toma","year":"2007","unstructured":"Al-Toma A, Verbeek WH, Hadithi M et al. Survival in refractory coeliac disease and enteropathy-associated T-cell lymphoma: retrospective evaluation of single-centre experience. Gut 2007;56:1373\u20131378.","journal-title":"Gut"},{"key":"7727_CR20","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1053\/j.gastro.2008.10.013","volume":"136","author":"A Rubio-Tapia","year":"2009","unstructured":"Rubio-Tapia A, Kelly DG, Lahr BD et al. Clinical staging and survival in refractory celiac disease: a single center experience. Gastroenterology 2009;136:99\u2013353.","journal-title":"Gastroenterology"},{"key":"7727_CR21","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1186\/1471-230X-14-139","volume":"14","author":"F Biagi","year":"2014","unstructured":"Biagi F, Marchese A, Ferretti F et al. A multicentre case control study on complicated coeliac disease: two different patterns of natural history, two different prognoses. BMC Gastroenterol. 2014;14:139.","journal-title":"BMC Gastroenterol."},{"key":"7727_CR22","doi-asserted-by":"publisher","first-page":"430","DOI":"10.3109\/07853890.2014.913378","volume":"46","author":"F Biagi","year":"2014","unstructured":"Biagi F, Vattiato C, Agazzi S et al. A second duodenal biopsy is necessary in the follow-up of adult coeliac patients. Ann. Med. 2014;46:430\u2013433.","journal-title":"Ann. Med."},{"key":"7727_CR23","doi-asserted-by":"publisher","first-page":"882","DOI":"10.1017\/S0007114509301579","volume":"102","author":"F Biagi","year":"2009","unstructured":"Biagi F, Andrealli A, Bianchi PI et al. A gluten-free diet score to evaluate dietary compliance in patients with coeliac disease. Br. J. Nutr. 2009;102:882\u2013887.","journal-title":"Br. J. Nutr."},{"key":"7727_CR24","doi-asserted-by":"publisher","first-page":"e741","DOI":"10.1016\/j.cgh.2020.12.015","volume":"20","author":"A Schiepatti","year":"2022","unstructured":"Schiepatti A, Maimaris S, Nicolardi ML et al. Determinants and trends of adherence to a gluten-free diet in adult celiac patients on a long-term follow-up (2000\u20132020). Clin. Gastroenterol. Hepatol. 2022;20:e741\u2013e749.","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"7727_CR25","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1136\/gutjnl-2011-301346","volume":"62","author":"JF Ludvigsson","year":"2013","unstructured":"Ludvigsson JF, Leffler DA, Bai JC et al. The Oslo definitions for coeliac disease and related terms. Gut 2013;62:43\u201352.","journal-title":"Gut"},{"key":"7727_CR26","first-page":"00758","volume":"S1542\u20133565","author":"S Parker","year":"2021","unstructured":"Parker S, Palsson O, Sanders DS et al. functional gastrointestinal disorders and associated health impairment in individuals with celiac disease. Clin. Gastroenterol. Hepatol. 2021;S1542\u20133565:00758\u201300768.","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"7727_CR27","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1177\/2050640614560786","volume":"3","author":"F Zingone","year":"2015","unstructured":"Zingone F, Swift GL, Card TR et al. Psychological morbidity of celiac disease: a review of the literature. United Eur. Gastroenterol. J. 2015;3:136\u2013145.","journal-title":"United Eur. Gastroenterol. J."},{"key":"7727_CR28","doi-asserted-by":"publisher","first-page":"1504","DOI":"10.1016\/S0140-6736(01)06581-3","volume":"358","author":"DS Sanders","year":"2001","unstructured":"Sanders DS, Carter MJ, Hurlstone DP et al. Association of adult coeliac disease with irritable bowel syndrome: a case-control study in patients fulfilling ROME II criteria referred to secondary care. Lancet 2001;358:1504\u20131508.","journal-title":"Lancet"},{"key":"7727_CR29","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/j.cgh.2012.11.033","volume":"11","author":"A Sainsbury","year":"2013","unstructured":"Sainsbury A, Sanders DS, Ford AC. Prevalence of irritable bowel syndrome-type symptoms in patients with celiac disease: a meta-analysis. Clin. Gastroenterol. Hepatol. 2013;11:359\u2013365.","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"7727_CR30","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1111\/apt.14991","volume":"48","author":"JF Ludvigsson","year":"2018","unstructured":"Ludvigsson JF, Lebwohl B, Chen Q et al. Anxiety after coeliac disease diagnosis predicts mucosal healing: a population-based study. Aliment. Pharmacol. Ther. 2018;48:1091\u20131098.","journal-title":"Aliment. Pharmacol. Ther."},{"key":"7727_CR31","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1017\/S0007114518003616","volume":"121","author":"A Schiepatti","year":"2019","unstructured":"Schiepatti A, Bellani V, Perlato M et al. Inadvertent and minimal gluten intake has a negligible role in the onset of symptoms in patients with coeliac disease on a gluten-free diet. Br. J. Nutr. 2019;121:576\u2013581.","journal-title":"Br. J. Nutr."},{"key":"7727_CR32","doi-asserted-by":"publisher","first-page":"1933","DOI":"10.1038\/ajg.2014.355","volume":"109","author":"P Wacklin","year":"2014","unstructured":"Wacklin P, Laurikka P, Lindfors K et al. Altered duodenal microbiota composition in celiac disease patients suffering from persistent symptoms on a long-term gluten-free diet. Am. J. Gastroenterol. 2014;109:1933\u20131941.","journal-title":"Am. J. Gastroenterol."},{"key":"7727_CR33","doi-asserted-by":"publisher","first-page":"972","DOI":"10.1016\/j.dld.2021.02.019","volume":"53","author":"A Schiepatti","year":"2021","unstructured":"Schiepatti A, Bacchi S, Biagi F et al. Relationship between duodenal microbiota composition, clinical features at diagnosis, and persistent symptoms in adult coeliac disease. Dig. Liver Dis. 2021;53:972\u2013979.","journal-title":"Dig. Liver Dis."},{"key":"7727_CR34","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.jcmgh.2020.07.010","volume":"11","author":"V Dotsenko","year":"2021","unstructured":"Dotsenko V, Oittinen M, Taavela J et al. Genome-wide transcriptomic analysis of intestinal mucosa in celiac disease patients on a gluten-free diet and postgluten challenge. Cell. Mol. Gastroenterol. Hepatol. 2021;11:13\u201332.","journal-title":"Cell. Mol. Gastroenterol. Hepatol."},{"key":"7727_CR35","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.3390\/nu10081023","volume":"10","author":"L Roncoroni","year":"2018","unstructured":"Roncoroni L, Bascu\u00f1\u00e1n KA, Doneda L et al. A low FODMAP gluten-free diet improves functional gastrointestinal disorders and overall mental health of celiac disease patients: a randomized controlled trial. Nutrients 2018;10:1023.","journal-title":"Nutrients"},{"key":"7727_CR36","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1111\/apt.12164","volume":"37","author":"B Lebwohl","year":"2013","unstructured":"Lebwohl B, Granath F, Ekbom A et al. Mucosal healing and mortality in coeliac disease. Aliment. Pharmacol. Ther. 2013;37:332\u2013339.","journal-title":"Aliment. Pharmacol. Ther."},{"key":"7727_CR37","doi-asserted-by":"publisher","first-page":"1412","DOI":"10.1038\/ajg.2010.10","volume":"105","author":"A Rubio-Tapia","year":"2010","unstructured":"Rubio-Tapia A, Rahim MW, See JA et al. Mucosal recovery and mortality in adults with celiac disease after treatment with a gluten-free diet. Am. J. Gastroenterol. 2010;105:1412\u20131420.","journal-title":"Am. J. Gastroenterol."},{"key":"7727_CR38","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1016\/j.cgh.2020.03.038","volume":"19","author":"JP Stefanolo","year":"2021","unstructured":"Stefanolo JP, T\u00e1lamo M, Dodds S et al. Real-world gluten exposure in patients with celiac disease on gluten-free diets, determined from gliadin immunogenic peptides in urine and fecal samples. Clin. Gastroenterol. Hepatol. 2021;19:484\u2013491.","journal-title":"Clin. Gastroenterol. Hepatol."}],"container-title":["Digestive Diseases and Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10620-022-07727-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10620-022-07727-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10620-022-07727-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T03:36:20Z","timestamp":1689651380000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10620-022-07727-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,18]]},"references-count":38,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["7727"],"URL":"https:\/\/doi.org\/10.1007\/s10620-022-07727-x","relation":{},"ISSN":["0163-2116","1573-2568"],"issn-type":[{"value":"0163-2116","type":"print"},{"value":"1573-2568","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,18]]},"assertion":[{"value":"1 April 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 July 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 November 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 May 2023","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The co-author \"Federico Biagi\" e-mail address has been corrected.","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the ethical review board of IRCCS Pavia, ICS Maugeri, Pavia, Italy (protocol number 2381 CE, approved on 14th January 2020). The study protocol conforms to the ethical guidelines of the 1975 Declaration of Helsinki (6th revision, 2008) as reflected in a priori approval by the institution's human research committee.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}