Is a gluten-free diet enough to treat celiac disease?

Abstract

Celiac disease  is a chronic gluten-induced autoimmune enteropathy in genetically predisposed individuals with specific HLA genotypes carrying the  DQ2 (DQA1*0501 and DQB1*0201) or DQ8 (DQA1*0301 and DQB1*0302) alleles. The overall  global prevalence of celiac  disease  is 0.7–1.4%. The increase  in the  incidence  rate  is associated with  significant  consumption of gluten  over the  last  century, which has a peculiar  effect  on the  small intestine mucosa. Atrophic processes in the  intestine mucosa contribute to malabsorption and development of gluten-dependent clinical symptoms, however, the manifestation of the disease  can occur at any age. The small intestine disease  with the development of hyper-regenerative atrophy of the small intestine mucosa  is recognized  as a systemic  disease  accompanied by various deficiency conditions  both  with and  without atrophy of the small intestine mucosa. Long-term adherence to a gluten-free diet entails  certain deficiency conditions, such as vitamins B, vitamin D, calcium, iron, and folic acid deficiencies, as well as a decrease in body mass index. To ensure  adequate nutritional intake, patients with celiac disease  require additional resources, namely specialized  dietary nutrition  products. The issues  of understanding the  need  for enteral nutrition  in the  management of patients with celiac disease  are stressed.  The article  presents a clinical observation of the  nutritional support  for a female  patient  with a typical course  of celiac disease, grade 2 protein-energy malnutrition, which demonstrated that the use of specialized  food products  as additional nutrition  can significantly improve the nutritional status  and somatometric indicators  in a patient  with celiac disease  on a gluten-free diet.