Non-Responsive Coeliac Disease: A Comprehensive Review from the NHS England National Centre for Refractory Coeliac Disease

Coeliac disease is a common small intestinal enteropathy which manifests following ingestion of gluten in genetically susceptible individuals. Since gluten was identified as the driving factor in coeliac disease, the gluten-free diet (GFD) has remained the mainstay of treatment. While most individua...

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Bibliographic Details
Published in:Nutrients 2020-01, Vol.12 (1), p.216
Main Authors: Penny, Hugo A, Baggus, Elisabeth M R, Rej, Anupam, Snowden, John A, Sanders, David S
Format: Article
Language:English
Subjects:
Adult
Antibodies
Atrophy
Biopsy
Celiac disease
Celiac Disease - complications
Celiac Disease - diet therapy
coeliac disease
Diet
Diet, Gluten-Free
England
Female
Gluten
gluten free diet
Glutens - analysis
Histology
Humans
Inflammation
Inflammatory bowel disease
Ingestion
Intestine
Irritable bowel syndrome
Lactose
Malabsorption Syndromes - complications
Malabsorption Syndromes - diet therapy
Male
non-responsiveness
Patient Compliance
Probiotics
refractory coeliac disease
Review
Serology
Signs and symptoms
State Medicine
Treatment Failure
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Description
Summary:Coeliac disease is a common small intestinal enteropathy which manifests following ingestion of gluten in genetically susceptible individuals. Since gluten was identified as the driving factor in coeliac disease, the gluten-free diet (GFD) has remained the mainstay of treatment. While most individuals will display improvement in symptoms and signs of coeliac disease following institution of the GFD, up to 30% will continue to experience symptoms and/or have persisting intestinal inflammation. These individuals can be classified as having non-responsive coeliac disease (NRCD), which may be associated with dietary indiscretion, slow healing, refractory coeliac disease, and/or an alternative condition. The purpose of this review is to provide an overview of the causes of NRCD in adults, highlight a systematic approach to investigate these patients, and appraise the latest management aspects of this subset of coeliac disease.
ISSN:2072-6643
2072-6643
DOI:10.3390/nu12010216