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For people with celiac disease, a lifelong strict gluten-free diet is the only effective treatment to date; [23] [69] For people diagnosed with non-celiac gluten sensitivity, there are still open questions concerning for example the duration of such a diet.
Early diagnosis and treatment with a gluten-free diet can improve ataxia and prevent its progression. 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. [57] [58]
For people eating a gluten-free diet who are unable to perform an oral gluten challenge, an alternative to identify a possible celiac disease is an in vitro gliadin challenge of small bowel biopsies, but this test is available only at selected specialized tertiary-care centers. [5]
Treatment: Gluten-free diet [13] Frequency ~1 in 135 [14] Coeliac disease (British English) or celiac disease (American English) is a long-term autoimmune disorder, ...
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]
The only available treatment for celiac disease is a strict gluten-free diet in which the affected person does not ingest any gluten-containing products. There have been searches for an affordable and much better treatment, but the only treatment remains to abstain from ingesting any gluten. [19]
Gluten-free diet: A diet which avoids the protein gluten, which is found in barley, rye and wheat. It is a medical treatment for gluten-related disorders, which include coeliac disease, non-celiac gluten sensitivity, gluten ataxia, dermatitis herpetiformis and wheat allergy. [50] [51] [52] [53]
A strict gluten-free diet is the first-line treatment, which should be started as soon as possible. It is effective in most of these disorders. When dementia has progressed to an advanced degree, the diet has no beneficial effect. Cortical myoclonus appears to be treatment-resistant on both gluten-free diet and immunosuppression. [14]
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