Coeliac disease and noncoeliac wheat or gluten sensitivity.

Abstract:

:Coeliac disease (CD) and noncoeliac wheat or gluten sensitivity (NCWS/NCGS) are common gluten-related disorders. Both conditions can present with gastrointestinal and extraintestinal manifestations, which can be a challenge for physicians to discern between. Whilst coeliac serology and histological assessment are required for the diagnosis of CD, there are no clear biomarkers for the diagnosis of NCGS. The management of both conditions is with a gluten-free diet (GFD), although the duration, as well as strictness of adherence to a GFD in NCGS, is unclear. Adherence to a GFD in CD can also be challenging, with recent developments of noninvasive assessments, although histological assessment via duodenal biopsies remains the gold standard. The management of refractory coeliac disease remains particularly challenging, often requiring specialist input. Whilst wheat is noted to be a trigger for symptom generation in NCGS, it is unclear which components of wheat are responsible for symptom generation in this group, with further research required to elucidate the pathophysiology.

journal_name

J Intern Med

authors

Rej A,Aziz I,Sanders DS

doi

10.1111/joim.13120

subject

Has Abstract

pub_date

2020-11-01 00:00:00

pages

537-549

issue

5

eissn

0954-6820

issn

1365-2796

journal_volume

288

pub_type

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