Papafragkakis
Charilaos Papafragkakis, MD
Gastroenterologist - Hepatologist

Gluten-Free Diet

24 Ιουν 2019 / Treatment of Celiac disease

Gluten-free diet has been the mainstay of treatment of celiac disease and gluten-free products and diets have become common in grocery stores, supermarkets, cookbooks and slowly find their place in restaurant menus.  Nowadays, gluten-free diet consumers do not necessarily have celiac disease, but are healthy people, willing to try gluten-free diets, which seem to have become a synonym for healthy. Gluten-free diets have been suggested as promising weight loss diets and for various medical conditions. In 2016 an analysis of the national health and nutrition examination survey of the United States found that gluten restriction in the absence of celiac disease has tripled between 2009 and 2014.

If someone starts a gluten-free diet, particularly if it’s without the advice of a dietitian, may end up in a low fiber diet that may lead to constipation, or abnormalities in their bowel habits. Also it’s difficult to follow a strict gluten-free diet both in terms of cost and convenience. Many products are expensive and people have hard time finding gluten-free menus in restaurants, since there is still unawareness about the disease and its common prevalence in the population.

Celiac disease used to be considered a very rare disease. In 2003 a study was published that showed that close to 1% of all individuals has celiac disease. The majority of patients with celiac disease were undiagnosed. In many cases of undiagnosed celiac disease, but in the presence of symptoms, gluten-free diet has been used with resolution of symptoms.

With gluten-free diet there is normalization of blood tests. It typically takes 6 to 12 months for specific antibodies to become normal after gluten-free diet implementation. In gastroscopy there is also normalization of duodenal biopsies. The abnormalities seen with celiac disease usually disappear within a couple of years after starting gluten-free diet.

Patients with celiac disease can have serious symptoms or be asymptomatic. It is important to know that there is a condition where there is no definitive diagnosis of celiac disease, but there is an entity of gluten sensitivity without celiac disease, which is in a grey-zone, with unclear causes. These people do better with gluten-free diet.

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