Celiac Disease and Nonceliac Gluten Sensitivity: New Updates on Pathophysiology, Diagnosis, and Treatment

Dear Colleagues,

Celiac disease is an autoimmune disorder related to gluten that damages the intestine. Treatment involves adopting a gluten-free diet. However, some individuals have gluten sensitivity rather than celiac disease. Gluten sensitivity is a functional disorder that does not cause long-term organic damage. Patients with gluten sensitivity typically also require a gluten-free diet, but their tolerance threshold may be slightly higher than that of celiac patients, and some patients may improve over time.

Coeliac disease and gluten sensitivity affect 1–2% of people in North America and Europe, adding up to 17 million people, with 670,000 in the UK, including children. This condition causes general inflammation of the small intestine, which in turn causes inflammation of the body, including the skin, which may present as dermatitis herpetiformis. This leads to general fatigue and possibly increased bowel movements, depression, and anxiety. The condition is genetically inherited.  Diagnosis involves finding significantly increased levels of antibodies to endomysium and tissue transglutaminase, with either HLA-DQ2 or DQ8 genetic markers, and possibly performing an abnormal small intestinal biopsy in adults and finding inflammation and a decrease in the ratio of small intestinal villous height to crypt depth. Treatment requires a gluten-free diet, which involves avoiding the ingestion of gluten proteins in wheat flour, which is present in bread, as well as rye, barley, and, in some people, oats. Following diagnosis, subjects should be followed up at least annually by a medical professional.

This Special Issue will explore nutritional treatment plans for celiac disease and nonceliac gluten sensitivity, as well as subsequent nutritional-related care. Contributions of original articles and reviews are welcome.

Prof. Dr. Paul J. Ciclitira
Guest Editor

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