Dietary compliance in celiac disease

作     者：Hugh James Freeman 

作者机构：Department of Medicine (Gastro-enterology) University of British Columbia 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2017年第23卷第15期

页      面：2635-2639页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Gluten-free diet Compliance Dietary recall Celiac disease Fecal immunoreactive peptides Tissue transglutaminase antibodies 

摘      要：Celiac disease is an immune-mediated disorder that causes severe architectural disturbance in the small intestinal mucosa of genetically-predisposed *** absorption of multiple nutrients results and diarrhea and weight loss *** has accumulated that a strict gluten-free diet can result in resolution of diarrhea,weight gain and normalization of nutrient *** addition,histopathological changes also normalize,but this histopathological res-ponse appears to be time-dependent,sex-dependent and *** to a gluten-free diet is difficult and costly resulting in poor compliance and only a limited clinical *** poses a risk for later long-term complications,including malignancy.A major practical clinical problem is the assessment of compliance to the gluten-free *** symptoms may resolve and serological antibody markers may improve,multiple studies have documented ongoing architectural disturbance and inflammatory change,and with these continued inflammatory changes,a persistent risk for long-term *** immunological studies have suggested that peptides can be detected in both urine and fecal specimens that may be indicative of limited *** the same time,multiple biopsy studies have demonstrated that complete normalization of the mucosa may occur in some patients within 6 mo of initiation of a gluten-free diet,but more often,up to 2 years or more may be required before repeated biopsies eventually show mucosal recovery and mucosal healing.