Nutrition Assessment in Celiac Disease

Simpson, Suzanne; Thompson, Tricia

doi:10.1016/j.giec.2012.07.010

Cited by 31 publications

(30 citation statements)

References 24 publications

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“…The gold standard for monitoring adherence to GFD is consultation with a skilled dietitian. 220 All serologic markers associated with celiac autoimmunity are gluten-dependent. A decrease from baseline values is expected within months of strict adherence to the GFD.…”

Section: Monitoring 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

1,452

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: Monitoring 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

1,452

1,539

View full text Add to dashboard Cite

show abstract

“…Topics of which the CD patient needs to be informed are the nutritional quality of the GFD and preventing contamination with gluten-containing foods [21]. Patients should also be trained to monitor for signs and symptoms of CD related problems and how individual responses vary.…”

Section: Discussionmentioning

confidence: 99%

Celiac Disease and the Gluten-free Diet: Registered Dietitian Nutritionists’ Self-reported Knowledge Varies

Geiger¹,

Rhee²,

Stastny³

et al. 2017

IJCD

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Background: Adherence to the gluten-free diet is the only treatment for celiac disease (CD) and some patients report lack of expertise among registered dietitian nutritionists (RDNs). Objective: To measure RDN self-reported celiac disease (CD) knowledge and preferences for resources for self-education and patient education. Methods: A cross-sectional research design was used to recruit RDNs from participating state affiliates Alaska, Colorado, Connecticut, Delaware, Montana, Nebraska, and North Dakota in 2013. A 35 item internet-based survey was distributed via Survey Monkey and included Likert scale questions based on a previous RDN allergy survey. Demographic and gluten-free diet and CD multiple-choice questions were also included. Results: Four-hundred and five registered dietitians (RDNs) who volunteered from the seven participating affiliates responded to the survey. Chi-squares were used to determine frequencies and differences in responses per variable. Pearson correlation analyses were performed to determine the correlation of age, education level, years of practice, or number of CD patients seen per week and CD self-reported knowledge. RDNs reported either moderate or high levels of knowledge for all seven self-reported knowledge topics. Over 85% of RDNs selected correct answers for five CD knowledge questions. Professional and academic publications were the most commonly used resources by RDNs for self-education whereas handouts were the most commonly used resource by RDNs for patient education. Conclusion: RDNs may need more reinforcement on identification and treatment of nutritional deficiencies of CD management.

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“…This is mainly due to "cross-contamination", which arises from eating at a table with other people who eat bread or other wheat products and who often inadvertently drop small fragments of foods that have been contaminated with flour residues during their preparation or handling, etc. It may also be due to the "hidden gluten" that is present in some products that are not adequately labeled [11,12]. People with a basic elementary education and/or with little understanding of how to follow a GFD, or who have little motivation, often believe that they are following the diet strictly, although in practice, they are frequently making mistakes [13].…”

Section: Evolutionary Clinical Follow-upmentioning

confidence: 99%

Evaluation of Efficacy and Adherence to Gluten-Free Diet in Patients with Celiac Disease

Rodrigo¹,

Pérez‐Martínez²,

Lauret-Braña³

et al. 2018

Preprint

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Celiac disease (CD) is a genetically conditioned autoimmune process that appears in susceptible people. It can affect people of any age, and slightly predominates in females. It has a fairly homogenous global distribution, with an average prevalence of 1-2%, the frequency having increased in recent decades. The only effective treatment is a strict and permanent gluten-free diet (GFD), although the level of compliance with it is poor, at about 50% of cases. To monitor the effectiveness of the GFD, several procedures involving various approaches are employed: a) periodic interviews by nutritionists; b) clinical follow-up; c) serological controls of specific antibodies; d) endoscopies with collection of duodenal biopsies; e) structured questionnaires; f) determination of gluten peptides derived from gluten in feces and/or urine. All of these procedures are useful when applied, alone or in combination, depending on the cases. Some patients will only need to consult to their doctors, while others will require a multidisciplinary approach to assess their compliance with the GFD. In children, normalization of duodenal mucosa was achieved in 95% of cases within 2 years, while it is more delayed in adults, whose mucosa take longer to heal completely.

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Nutrition Assessment in Celiac Disease

Cited by 31 publications

References 24 publications

ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease

ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease

Celiac Disease and the Gluten-free Diet: Registered Dietitian Nutritionists’ Self-reported Knowledge Varies

Evaluation of Efficacy and Adherence to Gluten-Free Diet in Patients with Celiac Disease

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