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This condition is known as refractory coeliac disease (RCD), defined as malabsorption due to gluten-related enteropathy (villous atrophy or elevated intraepitheal lymphocytes) after initial or subsequent failure of a strict gluten-free diet (usually 1 year) and after exclusion of any disorder mimicking coeliac disease. [106] [107]
Coeliac disease (British English) or celiac disease (American English) is a long-term autoimmune disorder, primarily affecting the small intestine, where individuals develop intolerance to gluten, present in foods such as wheat, rye, spelt and barley. [10]
There are indications that patients with non-coeliac gluten sensitivity show a reappearance of symptoms in far shorter time than is the case for coeliac disease: in non-coeliac gluten sensitivity, symptoms usually relapse in a few hours or days of gluten challenge. [13] [14]
The degree of gluten cross contamination tolerated by people with non-celiac gluten sensitivity is not clear but there is some evidence that they can present with symptoms even after consumption of small amounts. [37] Sporadic accidental contaminations with gluten can reactivate movement disorders associated with non-celiac gluten sensitivity. [72]
The effectiveness of the treatment depends on the elapsed time from the onset of the ataxia until diagnosis, because the death of neurons in the cerebellum as a result of gluten exposure is irreversible. [80] [81] Gluten ataxia accounts for 40% of ataxias of unknown origin and 15% of all ataxias.
Non-celiac gluten sensitivity (NCGS) or gluten sensitivity [14] is a controversial disorder which can cause both gastrointestinal and other problems. NCGS is included in the spectrum of gluten-related disorders. [3] [4] The definition and diagnostic criteria of non-celiac gluten sensitivity were debated and established by three consensus ...
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There is a growing body of evidence that the gluten-sensitive intestine differs from the normal gut, several gluten peptides can enter behind the brush border membrane cells. For example, a "33mer" of α-2 gliadin is a magnitude larger than the size exclusion of the tight junction, ω-5 gliadin peptides have been found in the blood stream of ...