Indications and use of the gluten contamination elimination diet for patients with non-responsive celiac disease
Abstract
For the majority of patients diagnosed with celiac disease, once a gluten-free diet is initiated, symptoms improve within weeks and may completely resolve in months. However, up to 30% of patients may show signs, symptoms or persistent small intestinal damage after one year on a gluten-free diet. These patients require evaluation for other common GI etiologies and assessment of their celiac disease status in order to make a diagnosis and suggest treatment. Here, we propose an approach to evaluating patients with celiac disease with persistent symptoms, persistently elevated serology, and or persistent villous atrophy despite a gluten-free diet. We detail how to diagnose and distinguish between non-responsive and refractory celiac disease. Finally, we introduce the indications for use of the gluten contamination elimination diet and provide information for practitioners to implement the diet when necessary in their practice. Copyright 2017 by the authors.Keyword
CeliacCeliac disease
Gluten
Gluten contamination elimination
Gluten-free diet
Non-responsive
Refractory
Identifier to cite or link to this item
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85032872805&doi=10.3390%2fnu9101129&partnerID=40&md5=b17593b9d1d8077e71e9d8c0c575e756; http://hdl.handle.net/10713/11072ae974a485f413a2113503eed53cd6c53
10.3390/nu9101129
Scopus Count
Collections
Related articles
- ACG clinical guidelines: diagnosis and management of celiac disease.
- Authors: Rubio-Tapia A, Hill ID, Kelly CP, Calderwood AH, Murray JA, American College of Gastroenterology.
- Issue date: 2013 May
- Trace gluten contamination may play a role in mucosal and clinical recovery in a subgroup of diet-adherent non-responsive celiac disease patients.
- Authors: Hollon JR, Cureton PA, Martin ML, Puppa EL, Fasano A
- Issue date: 2013 Feb 28
- Benefits of a gluten-free diet for asymptomatic patients with serologic markers of celiac disease.
- Authors: Kurppa K, Paavola A, Collin P, Sievänen H, Laurila K, Huhtala H, Saavalainen P, Mäki M, Kaukinen K
- Issue date: 2014 Sep
- HLA-DQ-Gluten Tetramer Blood Test Accurately Identifies Patients With and Without Celiac Disease in Absence of Gluten Consumption.
- Authors: Sarna VK, Lundin KEA, Mørkrid L, Qiao SW, Sollid LM, Christophersen A
- Issue date: 2018 Mar
- Monitoring nonresponsive patients who have celiac disease.
- Authors: Krauss N, Schuppan D
- Issue date: 2006 Apr