Celiac disease patients who experience ongoing symptoms or persistent villous atrophy despite following a gluten-free diet for more than 12 months are classified as having non-responsive celiac disease (NRCD).
In many cases, NRCD is due to accidental or intentional gluten ingestion, which is resolved by identifying and eliminating the source(s) of gluten exposure. However, in some individuals, NRCD occurs even when the individual is strictly adherent to the gluten-free diet. The concern is that these individuals may suffer from refractory celiac disease (RCD), a rare condition in which the body fails to respond to a gluten-free diet and requires additional, often costly immunotherapy treatments. RCD can also increase the risk of mortality and developing lymphoma.
A new report from the Center for Celiac Disease Research, however, suggests that a small subgroup of individuals with NRCD may actually be reacting to minimal amounts of gluten - even less than the 10 mg per day threshold typically defined for individuals with celiac disease.
Researchers tracked 17 individuals who were put on a “Gluten Contamination Elimination Diet” (GCED) for 3-6 months, eating only whole, fresh, unprocessed foods. Fourteen of the 17 patients responded to the GCED, and 11 of those individuals were able to return to a traditional gluten-free diet without the return of symptoms or elevated blood levels, according to the report.
Of important note, six of the individuals had met the criteria for RCD prior to starting the GCED. After completing the diet, five of the six no longer met the criteria for RCD, suggesting that GCED may help other individuals avoid the costly treatments for RCD.
To read more about this study, download the full article.