John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive


Cœliac disease, gluten sensitivity and gluten free diet: What we should know and correct Volume 25, issue 2, Février 2018


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1 Université Paris Descartes
2 UMR1163 Laboratoire d’immunité intestinale Institut Imagine, Université Paris Descartes, Faculté de Médecine, France
3 Hôpital Européen Georges Pompidou, service d’hépato-gastro-entérologie, endoscopies digestives, 20 rue Leblanc 75015, Paris, France
4 Hôpital Necker Enfants Malades, service d’anatomopathologie, 149 Rue de Sèvres, 75015 Paris, France
* Tirés à part
  • Key words: celiac disease, non celiac gluten sensitivity, gluten free diet, FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols)
  • DOI : 10.1684/hpg.2017.1580
  • Page(s) : 173-80
  • Published in: 2018

Celiac disease (celiac gluten sensitivity) is a gluten induced enteropathy occurring in genetically predisposed people (HLA-DQ2/DQ8). Its frequency is around 1% in occidental countries with a majority of undiagnosed people. Screening is based on serum detection of specific antibodies (IgA/IgG anti-transglutaminase antibodies) and duodenal biopsies showing intraepithelial hyperlymphocytosis and villous atrophy. Treatment relies on a long life gluten free diet excluding wheat, rye and barley. Besides decrease of symptoms, it prevents bone, autoimmune and malignant complications. Gluten free diet is indicated in celiac disease and wheat allergy, however it remains more controversial in case of non celiac gluten sensitivity characterized by irritable bowel syndrome decreasing with gluten free diet but without detectable enteropathy.