TY - JOUR
T1 - Persisting Villous Atrophy and Adherence in Celiac Disease
T2 - What Does the Patient Want? What Should a Clinician Advise?
AU - Rej, Anupam
AU - Elli, Luca
AU - Sanders, David Surendran
N1 - Publisher Copyright:
Copyright © 2021 by The American College of Gastroenterology.
PY - 2021/5/1
Y1 - 2021/5/1
N2 - ABSTRACT: Adherence to a gluten-free diet in celiac disease remains challenging. Clinicians may view mucosal healing as crucial. From the patient's perspective, avoidance of an invasive upper endoscopy may be desirable. A fundamental misconception is that noninvasive tools including symptoms, serology, dietary adherence questionnaires, and novel gluten immunogenic peptides may detect ongoing villous atrophy rather than assess adherence. Duodenal biopsies are the only reliable method for assessment of mucosal healing-however, we as clinicians should provide patients with the uncertainties of this approach allowing them to make an informed decision on an individual basis.
AB - ABSTRACT: Adherence to a gluten-free diet in celiac disease remains challenging. Clinicians may view mucosal healing as crucial. From the patient's perspective, avoidance of an invasive upper endoscopy may be desirable. A fundamental misconception is that noninvasive tools including symptoms, serology, dietary adherence questionnaires, and novel gluten immunogenic peptides may detect ongoing villous atrophy rather than assess adherence. Duodenal biopsies are the only reliable method for assessment of mucosal healing-however, we as clinicians should provide patients with the uncertainties of this approach allowing them to make an informed decision on an individual basis.
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U2 - 10.14309/ajg.0000000000001244
DO - 10.14309/ajg.0000000000001244
M3 - Article
C2 - 33767095
AN - SCOPUS:85106069391
VL - 116
SP - 946
EP - 948
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
SN - 0002-9270
IS - 5
ER -