OVERVIEW

From food allergy to lactose intolerance, including coeliac disease and elimination diets: this module provides the tools to distinguish the main adverse food reactions, understand the diagnostic pathway and translate the diagnosis into appropriate dietary management, while avoiding unnecessary restrictions and unvalidated tests.

AIMS AND CONTENT

AIMS AND LEARNING OUTCOMES

The module aims to provide students with an integrated understanding of the main adverse reactions to food, focusing on classification, pathophysiological mechanisms, diagnostic approach and dietary-nutritional implications.

By the end of the module, students will be able to:
- describe and classify adverse food reactions, distinguishing immune-mediated from non-immune-mediated conditions;
- recognize the main clinical patterns of IgE-mediated, non-IgE-mediated and mixed food allergies;
- distinguish coeliac disease, wheat allergy and non-coeliac gluten/wheat sensitivity and identify the principles of their diagnostic work-up;
- explain the mechanisms, diagnosis and dietary management of the main food intolerances, particularly lactose intolerance;
- apply the principles of an appropriate elimination diet, assessing indications, nutritional adequacy and the risks of unnecessary restriction;
- critically appraise diagnostic tests and dietary approaches, distinguishing validated methods from procedures lacking adequate scientific evidence;
- use the acquired knowledge to discuss simple clinical-dietetic scenarios and propose appropriate nutritional management.

TEACHING METHODS

Any Student with documented Specific Learning Disorders (SLD), or with any special needs, shall reach out to the Lecturer(s) and to the dedicated SLD Representative in the Department before class begins, in order to liase and arrange the specific teaching methods and ensure proper achievement of the learning aims and outcomes.

The module comprises 10 hours of interactive classroom lectures. Teaching is integrated with guided questions, discussion of examples and short clinical-dietetic cases to develop the ability to distinguish different conditions and apply knowledge to nutritional management. Attendance follows the requirements of the Degree Programme regulations.

SYLLABUS/CONTENT

1. Definitions and classification of adverse food reactions: food hypersensitivity, allergy and intolerance; immune-mediated and non-immune-mediated conditions.
2. Food allergy: epidemiology, mechanisms and clinical manifestations; IgE-mediated, non-IgE-mediated and mixed forms; diagnostic principles and dietary management.
3. Gluten/wheat-related disorders: coeliac disease, wheat allergy and non-coeliac gluten/wheat sensitivity; differential diagnosis and principles of the gluten-free diet.
4. Elimination diets: indications, elimination and reintroduction, nutritional adequacy, prevention of deficiencies and inappropriate restrictions; the dietitian’s role.
5. Non-immune-mediated food intolerances: lactase deficiency, lactose malabsorption and lactose intolerance; main diagnostic tests and dietary management. Overview of other non-immune and pharmacological reactions (e.g. histamine/scombroid poisoning).
6. Food and functional gastrointestinal symptoms: dietary triggers and limitations in their interpretation.
7. Unvalidated tests and self-prescribed diets: recognition of practices lacking evidence and principles of evidence-based nutritional counselling.

RECOMMENDED READING/BIBLIOGRAPHY

Core materials:
- slides, diagrams and teaching materials provided by the lecturer on AulaWeb;
- consensus documents and guidelines discussed during the lectures.
- books: Manuale di gastroenterologia pediatrica, il pensiero scientifico editore ed.2023. Salvatore Cucchiara; Gastroenterologia ed epatologia pediatrica. Una guida pratica. Il pensiero scientifico editore ed.2021. C.Catassi e L.D’Antiga.

Recommended readings:
- consensus ESPGHAN gluten free diet
- guidelines ESPGHAN coeliac disease and food allergy
- Turnbull JL, Adams HN, Gorard DA. Aliment Pharmacol Ther. 2015;41:3-25;
- Misselwitz B et al. Gut. 2019;68:2080-2091;
- Dellon ES et al. Clin Gastroenterol Hepatol. 2022;20:2474-2484;
- Biesiekierski JR et al. Non-coeliac gluten sensitivity. Lancet. 2025;
- SIAIP-SIGENP consensus on the diagnosis of non-IgE-mediated and mixed gastrointestinal food allergies.

TEACHERS AND EXAM BOARD

LESSONS

Class schedule

The timetable for this course is available here: Portale EasyAcademy

EXAMS

EXAM DESCRIPTION

Oral examination within the assessment of the integrated course. The exam includes questions on the module syllabus and may include discussion of a short clinical-dietetic scenario, with particular attention to the correct classification of the adverse reaction, the appropriateness of the diagnostic work-up and dietary management. The module assessment contributes to the overall grade of the integrated course.

ASSESSMENT METHODS

The assessment is designed to verify achievement of the expected learning outcomes. To pass the examination, students must demonstrate knowledge of the classification and mechanisms of the main adverse food reactions, the ability to distinguish the main clinical and diagnostic patterns, and the ability to apply appropriate principles of dietary management and elimination diets.

The final evaluation considers: accuracy and completeness of knowledge; ability to connect different topics; appropriateness of clinical-dietetic reasoning; critical ability to distinguish validated methods from unsupported approaches; clarity of presentation and correct use of specialist terminology. The minimum passing level corresponds to essential achievement of the expected outcomes; higher grades require mastery, autonomous reasoning and the ability to apply knowledge to new situations.

FURTHER INFORMATION

Teaching materials are available on AulaWeb. Course page: https://corsi.unige.it/off.f/2026/ins/98258

Student consultation hours: by appointment, arranged by e-mail with the lecturer.

Students with specific learning disorders, disabilities or other special needs are encouraged to contact the lecturer and the relevant University/Department representatives in advance to agree on teaching and assessment arrangements in accordance with UniGe regulations.