Celiac Disease in Elderly Adults: Clinical, Serological, and Histological Characteristics and the Effect of a Gluten‐Free Diet

Casella, Silvia; Zanini, Bárbara; Lotti, Francesco; Villanacci, Vincenzo; Ricci, Chiara; Lanzini, Alberto

doi:10.1111/j.1532-5415.2012.03997.x

Cited by 48 publications

(50 citation statements)

References 35 publications

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“…While little is known about the precise dynamics of the reduction, a weakly positive individual may become negative within weeks of strict adherence to GFD. 56 After 6–12 months of adhering to a GFD, 80% of subjects will test negative by serology. 57 By 5 years, more than 90% of those adhering to the GFD will have negative serologies.…”

Section: Diagnosis Of Celiac Diseasementioning

confidence: 99%

ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease

Rubio–Tapia

Hill

Kelly

et al. 2013

American Journal of Gastroenterology

1,421

1,539

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This guideline presents recommendations for the diagnosis and management of patients with celiac disease. Celiac disease is an immune-based reaction to dietary gluten (storage protein for wheat, barley and rye) that primarily affects the small intestine in those with a genetic predisposition and resolves with exclusion of gluten from the diet. There has been a substantial increase in the prevalence of celiac disease over the last 50 years and an increase in the rate of diagnosis in the last 10 years. Celiac disease can present with many symptoms, including typical gastrointestinal symptoms (e.g. diarrhea, steatorrhea, weight loss, bloating, flatulence, abdominal pain) and also non-gastrointestinal abnormalities (e.g. abnormal liver function tests, iron deficiency anemia, bone disease, skin disorders, and many other protean manifestations). Indeed, many individuals with celiac disease may have no symptoms at all. Celiac disease is usually detected by serologic testing of celiac-specific antibodies. The diagnosis is confirmed by duodenal mucosal biopsies. Both serology and biopsy should be performed on a gluten-containing diet. The treatment for celiac disease is primarily a gluten-free diet (GFD), which requires significant patient education, motivation, and follow-up. Non-responsive celiac disease occurs frequently, particularly in those diagnosed in adulthood. Persistent or recurring symptoms should lead to a review of the patient’s original diagnosis to exclude alternative diagnoses, a review of the GFD to ensure there is no obvious gluten contamination, and serologic testing to confirm adherence with the GFD. In addition, evaluation for disorders associated with celiac disease that could cause persistent symptoms, such as microscopic colitis, pancreatic exocrine dysfunction, and complications of celiac disease, such as enteropathy-associated lymphoma or refractory celiac disease, should be entertained. Newer therapeutic modalities are being studied in clinical trials, but are not yet approved for use in practice. Given the incomplete response of many patients to a GFD free diet as well as the difficulty of adherence to the GFD over the long term, development of new effective therapies for symptom control and reversal of inflammation and organ damage are needed. The prevalence of celiac disease is increasing worldwide and many patients with celiac disease remain undiagnosed, highlighting the need for improved strategies in the future for the optimal detection of patients.

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Section: Diagnosis Of Celiac Diseasementioning

confidence: 99%

ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease

Rubio–Tapia

Hill

Kelly

et al. 2013

American Journal of Gastroenterology

1,421

1,539

View full text Add to dashboard Cite

show abstract

“…9 BMD seems to improve with treatment on a gluten free diet (GFD). [10][11][12] In adolescents, both low fat and lean body mass normalized after 1 year, 13 but studies in adults have either lacked measures beyond fat indices, used outdated antibody assays, and/or have not correlated changes with histology.…”

Section: Introductionmentioning

confidence: 96%

Adherence to the gluten‐free diet can achieve the therapeutic goals in almost all patients with coeliac disease: A 5‐year longitudinal study from diagnosis

Newnham

Shepherd

Strauss

et al. 2016

J of Gastro and Hepatol

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“…Ebenso liegt v. a. bei älteren Menschen ein erhöhtes Risiko für eine Osteoporose vor [57]. In einer Studie von GarciaManzanares et al wurde sogar eine Korrelation zwischen dem Grad der Zottenatrophie und der Abnahme der Knochendichte gezeigt [58]. Dabei ist die Osteoporose wahrscheinlich Folge eines initialen Vitamin-D-Mangels.…”

Section: Therapie Und Erkrankungsverlaufunclassified