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.