Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
, 88 (1), 157-70

Coeliac Disease

Affiliations
Review

Coeliac Disease

John S Leeds et al. Br Med Bull.

Abstract

Introduction: Coeliac disease is a common but often under diagnosed condition with important complications. It is due to immune-mediated gluten intolerance and may present in a number of ways. It has become more frequently diagnosed due to the recognition of the atypical presentations. In recent years, more sensitive and specific serological markers have been developed but the gold standard of diagnosis remains duodenal biopsy. Compliance with a strict, lifelong gluten-free diet is the cornerstone of management, improving symptoms and reducing complications of the disease.

Sources of data: For this review, we focused on papers published on coeliac disease in recent years. Particular emphasis was given to clinical papers examining new methods for the diagnosis of coeliac disease or newer therapies for managing complications. The main source was PubMed and the major gastroenterology journals.

Areas of agreement: Coeliac disease is more common than once thought with a prevalence of around 1%. Diagnosis should always be confirmed with a duodenal biopsy. Management of coeliac disease with a gluten-free diet remains the cornerstone of treatment.

Areas of controversy: Some complications of coeliac disease, especially neurological, are not widely accepted despite growing support from the literature. Management of enteropathy-associated lymphoma has been difficult, and the optimal therapy is not known.

Growing points: Current understanding is such that coeliac disease is the most widely understood autoimmune condition. 'Atypical' presentations are becoming the most common presenting features of coeliac disease.

Areas timely for developing research: Alternatives to the gluten-free diet are about to go into clinical studies. Similarly, better serological screening tests may obviate the need for duodenal biopsy. This review will try to summarize the current understanding of coeliac disease with regard to diagnosis, management, complications and future perspectives.

Similar articles

  • Clinical Response to Gluten Withdrawal Is Not an Indicator of Coeliac Disease
    J Campanella et al. Scand J Gastroenterol 43 (11), 1311-4. PMID 18609173.
    Clinical response to either withdrawal or re-introduction of dietary gluten has no role in the diagnosis of coeliac disease.
  • Issues Related to Gluten-Free Diet in Coeliac Disease
    R Troncone et al. Curr Opin Clin Nutr Metab Care 11 (3), 329-33. PMID 18403932. - Review
    Gluten-free diet remains the cornerstone of therapy of coeliac disease. More studies addressing the need of gluten-free diet for cases of 'potential' coeliac disease are …
  • Coeliac Disease: Current Approach and Future Prospects
    RP Anderson. Intern Med J 38 (10), 790-9. PMID 19143879. - Review
    Public anxiety over gluten has fuelled widespread demand for gluten-free food, yet coeliac disease remains significantly underdiagnosed and some confusion remains regardi …
  • Recent Advances in Coeliac Disease
    MJ Armstrong et al. Curr Opin Gastroenterol 25 (2), 100-9. PMID 19528877. - Review
    Despite the encouraging progress that has taken place in our genetic and immunological knowledge of coeliac disease, early introduction of a gluten-free diet remains the …
  • Advances in Celiac Disease
    RB Jones et al. Curr Opin Gastroenterol 22 (2), 117-23. PMID 16462166. - Review
    Despite recent advances in our understanding of celiac disease, the gluten-free diet remains the only current viable therapy and even with advances in serological tests a …
See all similar articles

Cited by 13 PubMed Central articles

See all "Cited by" articles

Publication types

Feedback