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Nutrients. 2018 Nov 18;10(11). pii: E1796. doi: 10.3390/nu10111796.

Gluten-Free Diet in Celiac Disease-Forever and for All?

Author information

1
Division of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany. alice.itzlinger@charite.de.
2
Division of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany. federica.branchi@charite.de.
3
Center for the Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy. luca.elli@policlinico.mi.it.
4
Division of Gastroenterology, Infectious Diseases and Rheumatology, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, 12203 Berlin, Germany. michael.schumann@charite.de.

Abstract

The gluten-free diet is the only effective treatment available for celiac disease. However, it is difficult to adhere to and a closer look on the diet's implementation and indications reveals several ambiguities: Not only is there controversy on the threshold of gluten that can be tolerated in the frame of a strict gluten-free diet, but it is also unclear whether the gluten-free diet is an appropriate treatment in patient subgroups with asymptomatic or potential celiac disease. Reports from a number of research groups suggest that a certain proportion of patients may effectively develop tolerance to gluten and thus become suitable for gluten reintroduction over time. In this review, we set out to create an overview about the current state of research as regards the definition of a strict gluten-free diet in terms of the gluten thresholds considered tolerable and the indication for a gluten-free diet in the absence of histological abnormalities or symptoms. Furthermore, we discuss the concept that a gluten-free diet must be followed for life by all patients.

KEYWORDS:

adherence; gluten; mucosal recovery; serology; threshold; villous atrophy

PMID:
30453686
PMCID:
PMC6267495
DOI:
10.3390/nu10111796
[Indexed for MEDLINE]
Free PMC Article

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