Non-Responsive Coeliac Disease: A Comprehensive Review from the NHS England National Centre for Refractory Coeliac Disease.
Study Goal
The researchers aimed to review the causes of non-responsive coeliac disease (NRCD) in adults, outline a systematic approach for investigation, and evaluate the latest management strategies for this subset of coeliac disease.
Results Summary
The study found that while most individuals with coeliac disease improve on a gluten-free diet (GFD), up to 30% experience persistent symptoms or inflammation, classified as NRCD, which may stem from dietary indiscretion, slow healing, refractory disease, or alternative conditions. The review highlights diagnostic and management approaches for NRCD.
Population
Adults with coeliac disease, particularly those with non-responsive symptoms.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
gluten-free diet (GFD) | decrease | symptoms and signs of coeliac disease | most individuals | - | improvement | #1 |
gluten-free diet (GFD) | no change | symptoms and/or persisting intestinal inflammation | up to 30% | up to 30% | continue to experience | #2 |
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.