The primary nutritional approach in pediatric celiac disease: a mini-review

Abstract

Background: Celiac disease (CD) is chronic small bowel inflammation with villous atrophy, consequently, an immune-mediated disorder triggered by ingesting Gluten in wheat, barley, and rye in genetically susceptible individuals. Aims: Summarize the fundamental principles for managing the diet of patients with CD. This Mini-Review using relevant articles in PubMed's online databases followed the medical keywords Celiac Disease, Gluten, gluten-free diet, nutritional approach, and diet adherence. The institution's Ethics Committee has waived the need to review the ethical aspects of this text. The cornerstone of the treatment is the lifelong adherence to a Gluten-Free Diet (GFD). This dietary regimen, which forms the basis of the patient's treatment, requires eliminating all food components containing Gluten and its derivatives from the diet. However, the treatment approach has changed from focusing on food avoidance to a wide-ranging evaluation of the various factors influencing the dietary choices in the patient's life. The Global Approach to the Follow-up of Celiac Disease is based on 1) control of symptomatology and dietary adherence; 2) improving emotional and social wellness in treating CD patients, with the active involvement of a psychologist; and 3) ensuring successful education of both the child and the family about its management. Indeed, the impact of CD extends beyond the patient and affects the well-being of caregivers and 4) evaluate socioeconomic burden, considering that Gluten-free food products remain significantly more expensive than gluten-containing equivalents with variable availability. So, the GFD is the primary treatment for CD, and difficulties in managing the Disease can lead to impaired Quality of Life. In conclusion, strict adherence to the GFD is imperative, requiring a multidisciplinary team involving physicians, dietitians, and psychologists on a regular visit schedule to assess dietary adherence and avoid long-term complications.