Non-responsive celiac disease

Elisa Stasi

Research output: Chapter in Book/Report/Conference proceedingChapter


Celiac disease is a chronic immune-mediated enteropathy triggered by the ingestion of gluten in genetically-predisposed individuals. Treatment of celiac disease is based on life-long adherence to a gluten-free dietary regimen.
Some celiac patients experience persistence or recurrence of symptoms after a period of well-being, despite an ongoing gluten-free diet. This condition, defined as non-responsive celiac disease, affects nearly one fifth of celiac patients and may be due to heterogeneous etiologies. Its occurrence warrants a correct assessment in order to optimize the management of celiac patients. This chapter focuses on available evidence on frequency and cause of non-responsive celiac disease, and on suggested investigations for the correct assessment and management of this condition.
The initial diagnosis of celiac disease should be reconsidered. In patients with confirmed diagnosis of celiac disease, a diet compliance assessment is among the first and mandatory steps to be undertaken, to differentiate non-responsive celiac disease from refractory celiac disease, as the latter carries a significantly different burden of clinical implications. Further laboratory tests, breath-tests, endoscopic and histologic evaluations are warranted according to the persistent symptoms/signs in order to identify alternative or concomitant disease presenting with symptoms which overlap those of celiac disease.
Once the cause of non-responsive symptoms has been identified it should be targeted accordingly in order to achieve symptoms improvement or resolution.
Original languageEnglish
Title of host publicationNova Publishers. Howard Rivera Editor
Place of PublicationNew York
ISBN (Electronic)978-1-53610-402-8, Howard Rivera Editor
Publication statusPublished - 2017


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