Dear editor,

In their interesting paper, Freeman et al. reported on the outcome of celiac patients after Roux-en-Y gastric bypass (RYGBP). In the selection of patients, they described that the initial group was reviewed for abnormal serology and/or pathology (n = 68) but only 3 had a diagnosis of celiac disease (CD) on the basis of AGA criteria [1].

In literature, it is reported that at least three disorders can be attributed to gluten: CD, wheat allergy, and non-celiac gluten sensitivity [2].

In their work, Freeman et al. did not report if the discrepancy between the original sample (68) and the considered sample (3) is due to the diagnosis of gluten disorders other than CD or to different causes (false positive serologic tests). I think that this point could enrich the work.