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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...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2017
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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. |
format | Online Article Text |
id | pubmed-5691745 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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