Review article: Systemic consequences of coeliac disease.

in Alimentary pharmacology & therapeutics by Pilvi Laurikka, Laura Kivelä, Kalle Kurppa, Katri Kaukinen

TLDR

  • Coeliac disease is a condition where the body's immune system reacts to gluten, a protein found in wheat, barley, and rye. This reaction can cause damage to the lining of the small intestine, leading to malabsorption of nutrients. However, coeliac disease can also cause problems outside the intestine, such as bone density issues, fertility problems, and an increased risk of certain cancers. Early diagnosis and treatment with a gluten-free diet can help manage these conditions, but it's important to monitor patients closely and be aware of the potential negative effects of the diet.

Abstract

The best-known symptoms of coeliac disease are related to the gastrointestinal tract, but the disease may also present with various systemic manifestations outside the intestine. Some of these consequences may remain permanent in undiagnosed individuals or if the diagnostic delay is prolonged. However, for many of the systemic manifestations, the scientific evidence remains scant and contradictory. We conducted a narrative review of the most thoroughly studied and clinically relevant systemic consequences of coeliac disease, especially those that could be prevented or alleviated by early diagnosis. The review is intended particularly for physicians encountering these patients in daily clinical practice. The possible systemic consequences of coeliac disease extend to multiple organ systems, the best studied of which are related to skeletal, reproductive, cardiovascular and neurological systems. Furthermore, the disease is associated with an elevated risk of psychiatric comorbidities, non-Hodgkin lymphomas and intestinal adenocarcinoma. The various systemic consequences of coeliac disease play a significant role in the overall health of patients. Early diagnosis and treatment with a gluten-free diet appear to be beneficial for most, but not all of these conditions. The possible negative metabolic and psychosocial effects of the diet should be acknowledged during follow-up.

Overview

  • The study focuses on the systemic consequences of coeliac disease, including those that can be prevented or alleviated by early diagnosis. The methodology involves a narrative review of the most thoroughly studied and clinically relevant systemic consequences of coeliac disease. The study aims to provide physicians with a comprehensive understanding of the possible systemic consequences of coeliac disease and their impact on patient health. The primary objective is to highlight the importance of early diagnosis and treatment with a gluten-free diet for managing these conditions.

Comparative Analysis & Findings

  • The study compares the outcomes observed under different experimental conditions or interventions, specifically early diagnosis and treatment with a gluten-free diet. The results show that early diagnosis and treatment can be beneficial for most, but not all of the systemic consequences of coeliac disease. However, the study also highlights the potential negative metabolic and psychosocial effects of the diet, which should be acknowledged during follow-up.

Implications and Future Directions

  • The study's findings highlight the importance of early diagnosis and treatment with a gluten-free diet for managing the systemic consequences of coeliac disease. However, the study also identifies the need for further research to better understand the long-term effects of the diet and to develop more effective interventions for managing these conditions. Additionally, the study suggests that physicians should be aware of the potential negative effects of the diet and monitor patients closely during follow-up.
Read Full Article