Systematic review: The evidence base for long-term management of coeliac disease

Alimentary Pharmacology & Therapeutics
M L HainesPeter R Gibson

Abstract

While gluten-free diet is an effective treatment for coeliac disease, the need for and goals of long-term management of patients are poorly defined. To review systematically the complications and associations of coeliac disease, to identify potential risk factors, to define ways of assessing risk factors and to provide a strategy for management. Review of medical literature from 1975. There is an increasing list of potential complications and/or conditions associated with coeliac disease, in particular, autoimmune disease, malignancy and bone disease. Risk factors that may predict or influence long-term outcomes include genetic susceptibility, environmental factors predominantly gluten ingestion, persistent small intestinal inflammation/injury and nutritional deficiencies. Genotyping of patients is yet to have an established clinical role in long-term management. Assessment of adherence to the gluten-free diet largely relies upon skilled dietary history, but the ultimate test is duodenal histopathology, which is the only currently established means of assessing healing. Symptoms, serology or other non-invasive means are poor predictors of healing and the likelihood of complications. Evidence (albeit limited) that adherence to a...Continue Reading

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Mar 31, 2011·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Alvaro García-Manzanares, Alfredo J Lucendo
Apr 20, 2011·Journal of Pediatric Gastroenterology and Nutrition·Charlotta WebbOlof Sandström
Apr 20, 2011·The American Journal of Gastroenterology·Satu KorpimäkiMarja-Leena Lähdeaho
Jan 29, 2019·Gastroenterology Nursing : the Official Journal of the Society of Gastroenterology Nurses and Associates·Stefania PaganizzaCristina Canova
Feb 11, 2010·The American Journal of Gastroenterology·Alberto Rubio-TapiaJoseph A Murray
Mar 16, 2019·International Journal of Adolescent Medicine and Health·Dory Sample, Justine Turner
Jan 15, 2014·Expert Review of Gastroenterology & Hepatology·Thimmaiah G TheethiraD A Leffler
Apr 3, 2014·Journal of Pediatric Gastroenterology and Nutrition·Youssef GhazzawiImad Absah
Feb 10, 2012·Alimentary Pharmacology & Therapeutics·T A KabbaniD A Leffler
Sep 17, 2016·Journal of Clinical Gastroenterology·Stephan R VavrickaThomas Greuter
Jan 12, 2019·Nature Reviews. Disease Primers·K LindforsK Kaukinen
Mar 6, 2020·Frontline Gastroenterology·Lucy PritchardStephen Lewis
Sep 12, 2012·Journal of Immunoassay & Immunochemistry·Naiyana GujralHoon H Sunwoo
Jun 9, 2015·World Journal of Hepatology·Janaína Luz Narciso-Schiavon, Leonardo de Lucca Schiavon
Jan 1, 2014·International Scholarly Research Notices·Anu Garg, Rajkumar Gupta
Sep 7, 2017·Journal of Clinical Gastroenterology·Julio C Bai, Carolina Ciacci
Oct 27, 2020·JGH Open : an Open Access Journal of Gastroenterology and Hepatology·Ashish AgarwalGovind K Makharia
Jan 19, 2020·Journal of the Academy of Nutrition and Dietetics·Feon W Cheng, Deepa Handu
May 31, 2021·Scandinavian Journal of Gastroenterology·Frida van MegenChristine Henriksen

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