Treatment failure in coeliac disease: a practical guide to investigation and treatment of non-responsive and refractory coeliac disease.
Study Goal
The researchers aimed to investigate the effectiveness of a gluten-free diet in patients with coeliac disease, distinguishing between non-responsive coeliac disease and refractory coeliac disease, and to discuss management options.
Results Summary
The study found that while most patients with coeliac disease respond well to a gluten-free diet with symptom resolution and histological improvement, a significant minority experience persistent issues, including refractory coeliac disease, which can lead to severe complications like malabsorption and lymphoma.
Population
European adult population with coeliac disease.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
gluten free diet | decrease | symptoms | majority of patients with coeliac disease | - | resolution of symptoms | #1 |
gluten free diet | increase | histology | majority of patients with coeliac disease | - | improvement in histology | #2 |
Coeliac disease is a common condition affecting up to 1% of the European adult population. Whilst the majority of patients will respond to a gluten free diet with resolution of symptoms and an improvement in histology, a significant minority have persistent problems. Refractory coeliac disease is a relatively uncommon cause of non-response to gluten free diet with potentially serious consequences of severe malabsorption and a high rate of progression to lymphoma. This review provides a practical guide to the investigation of patients who do not respond to a gluten free diet. We will highlight the differences between the more common non-responsive coeliac disease and the rare entity of refractory coeliac disease and discuss current management and treatment options for both non-responsive coeliac disease and refractory coeliac disease.