Medical Follow-up of Celiac Patients

Alberto Rubio-Tapia

Resumen


This chapter presents practical recommendations for the medical follow-up of patients with celiac disease. The gluten-free diet is currently the only available treatment for celiac disease. Patients with celiac disease require lifelong adherence to the gluten-free diet and medical follow-up. The benefits of strict adherence to the gluten-free diet including control of symptoms, seroconversion, and mucosal healing are discussed in detail. Despite extensive evidence of the benefits of the strict adherence to the gluten-free diet, rates of compliance and medical follow-up in clinical practice are less than optimal. The advantages and limitations of the four methods currently available for assessment of compliance to gluten-free diet (detailed dietary history, serology, histology and structured questionnaires) are summarized. Expert opinion and guidelines endorsed by several Medical Societies agree on the necessity of a medical follow-up; however, there is no universal consensus about how to perform said medical follow-up in daily practice. An algorithm for the medical follow-up of celiac disease patients is suggested based on available evidence and the author’s institutional experience, which includes regular medical follow-up, annual serology measurement, evaluation of a detailed dietary history, assessment of clinical response and correction of nutritional deficiencies.

Palabras clave


celiac, follow-up

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