Gluten intolerance is thought to affect many people worldwide and results in a myriad of symptoms that adversely affect quality of life. Those with an innate or adaptive immune-mediated enteropathy to gluten (coeliac disease), an antigen-triggered allergic reaction to gluten (gluten allergy) or sensitivity to ingested gluten-containing foods (non-coeliac gluten sensitivity) have gluten-related disorders. Signs and symptoms of these disorders are often indistinguishable, but the pathogenic processes vary, with potential health consequences. The nurse practitioner must: have a high index of suspicion for gluten-related conditions in individuals with a history of gastrointestinal symptoms; assure appropriate screening and testing is undertaken; assist in establishing a gluten-free diet; and manage associated health conditions so that optimal health and quality of life can be attained.