Celiac disease: the true and the false

Pierre H. Deprez Published in the journal : May 2018 Category : Congrès UCL de Médecine Générale

Summary :

Celiac disease is a chronic enteropathy induced by dietary gluten in genetically predisposed patients (HLA-DQ2/DQ8). The diagnosis is based on positive anti-transglutaminase and anti-deamidated gliadin antibodies, followed by duodenal histology showing the intraepithelial lymphocytic infiltration and villous atrophy. The treatment consists in a lifelong adherence to a strict gluten-free diet, without wheat, rye, and barley. The gluten-free diet allows the intestinal villi to heal, which leads to symptom resolution. While gluten-free diet is of paramount importance in celiac disease and wheat allergy, its role in gluten hypersensitivity remains controversial. Indeed, several studies have shown that a fructan-free diet (part of the so-called FODMAPs) would be preferable in these non-celiac patients.

What is already known about the topic?

Celiac disease or gluten intolerance is a well-defined enteropathy, unlike gluten hypersensitivity

What does this article bring up for us?

This article recalls the pathophysiological basis of celiac disease and proposes hypotheses for explaining gluten hypersensitivity.

Key Words

Celiac disease, intolerance, physiopathology, gluten hypersensitivity, fructan