## 4 Self-Evaluation of GFD Correctness: Gluten Detection Tests  
Noninvasive tools, including symptoms, serology (serum antibodies), dietary adherence questionnaires, and novel gluten immunogenic peptides, may detect ongoing villous atrophy rather than assess adherence to a GFD as in an invasive examination. The measurement of serum antibodies, in which a blood sample must be taken at a clinical laboratory or outpatient clinic, can also be determined today by using recently developed tools for self-assessment of serum antibody levels [43]. However, it must be kept in mind that we still need to settle the debate as to whether CD-related antibodies (TTG, EMA, and DGP) are reliable and accurate enough to assess adherence to a GFD, which is a critical step in evaluating the clinical course of CD during follow-up. On the other hand, nutritional follow-up is essential in these patients (Table 1). Today, new techniques using online questionnaires facilitate obtaining data both for a nutritional evaluation and adherence to a GFD. In addition, CD-specific health-related quality of life and food interviews allow the personalization of a GFD and the prescription of indications as needed. Furthermore, the introduction of point-of-care testing to evaluate the presence of gluten peptides in urine could be an efficient method for self-monitoring a GFD [44]. Monitoring the GFD remains a pivotal issue. Even if certified alimentary products are available, special attention must be paid to gluten contamination. The nutritionist should support the patient in the correct food choices, explaining how to choose gluten-free packaged products, including pasta, bread, and biscuits, which can be included in the diet in association with a balanced macro- and micronutrient intake. Products with the certified gluten-free trademark must be chosen, paying attention to avoid foods with \"traces\" of gluten shown on the food label [45]. Considering that gluten-free cooking may involve some difficulties, cooking at home could represent a risk of gluten contamination. Although professional nutritional telehealth support is an effective option today, patients themselves can successfully monitor and verify their eventual ingestion of gluten. We do not know if the diet needs to be as strict over time [46], but several on-the-spot techniques are now available which allow measuring urinary gluten peptides, fecal peptides, and blood antibodies; patients can easily control these at home when in doubt of gluten ingestion or when unexplained symptoms occur. The use of multiple modalities to self-monitor the GFD could help, providing an important support to verify possible and unconscious gluten ingestion or contamination. The self-dosage test of gluten urinary peptides works via an immunodromatographic technique that uses the G12 monoclonal antibody (MoAb), which is able to detect GIP in urine within the previous 24-48 h [47; 48; 49]. Self-administered point-of-care tests are easy to use, convenient, cheap, trustworthy, and precise tools which can be used to indicate possible gluten contamination even during remote telehealth monitoring [50]. It is likely that these tools could increase the sensitivity to detect adherence problems. This is also a key aspect in the case of children with a gluten-related disorder, as their caregivers must be trained in using these alternatives.