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Indications and Use of the Gluten Contamination Elimination Diet for Patients with Non-Responsive Celiac Disease

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. Th...

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Autores principales: Leonard, Maureen M., Cureton, Pamela, Fasano, Alessio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5691745/
https://www.ncbi.nlm.nih.gov/pubmed/29057833
http://dx.doi.org/10.3390/nu9101129
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author Leonard, Maureen M.
Cureton, Pamela
Fasano, Alessio
author_facet Leonard, Maureen M.
Cureton, Pamela
Fasano, Alessio
author_sort Leonard, Maureen M.
collection PubMed
description 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.
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spelling pubmed-56917452017-11-22 Indications and Use of the Gluten Contamination Elimination Diet for Patients with Non-Responsive Celiac Disease Leonard, Maureen M. Cureton, Pamela Fasano, Alessio Nutrients Article 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. MDPI 2017-10-18 /pmc/articles/PMC5691745/ /pubmed/29057833 http://dx.doi.org/10.3390/nu9101129 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Leonard, Maureen M.
Cureton, Pamela
Fasano, Alessio
Indications and Use of the Gluten Contamination Elimination Diet for Patients with Non-Responsive Celiac Disease
title Indications and Use of the Gluten Contamination Elimination Diet for Patients with Non-Responsive Celiac Disease
title_full Indications and Use of the Gluten Contamination Elimination Diet for Patients with Non-Responsive Celiac Disease
title_fullStr Indications and Use of the Gluten Contamination Elimination Diet for Patients with Non-Responsive Celiac Disease
title_full_unstemmed Indications and Use of the Gluten Contamination Elimination Diet for Patients with Non-Responsive Celiac Disease
title_short Indications and Use of the Gluten Contamination Elimination Diet for Patients with Non-Responsive Celiac Disease
title_sort indications and use of the gluten contamination elimination diet for patients with non-responsive celiac disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5691745/
https://www.ncbi.nlm.nih.gov/pubmed/29057833
http://dx.doi.org/10.3390/nu9101129
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