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Gluten tolerance; potential challenges in treatment strategies.

Bold J, Rostami K - Gastroenterol Hepatol Bed Bench (2011)

Bottom Line: It is estimated that daily consumption of gluten from contaminated gluten free foods is in the range of 5 to 50 mg.Conversely, it seems there is evidence that some patients might have a much lower threshold for gluten.Whatever would be the individual threshold, GFD may be of benefit to any symptomatic patients even those with milder enteropathy like microscopic enteritis.

View Article: PubMed Central - PubMed

Affiliation: Institute of Health, Social Care and Psychology University of Worcester UK.

ABSTRACT
Tolerable gluten thresholds in gluten free products have long been debated together with issues of cross contamination of gluten free cereals during the milling process. It is well established that a totally gluten free diet is virtually impossible owing to the presence of traces of gluten. It is estimated that daily consumption of gluten from contaminated gluten free foods is in the range of 5 to 50 mg. We believe evidence is mounting that it may be possible for some coeliac patients to tolerate gluten above the limits considered permissible at threshold levels. Conversely, it seems there is evidence that some patients might have a much lower threshold for gluten. Whatever would be the individual threshold, GFD may be of benefit to any symptomatic patients even those with milder enteropathy like microscopic enteritis.

No MeSH data available.


Related in: MedlinePlus

Gluten free diet guide. * The subgroup with a potential higher gluten tolerance need to be defined in future studies.
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Figure 0001: Gluten free diet guide. * The subgroup with a potential higher gluten tolerance need to be defined in future studies.

Mentions: When presentation is atypical, it can be a challenge to identify a patient where a GFD may be of benefit. Similarly, identification of the subgroups that may need less restriction with their gluten intake could also be extremely difficult (Figure 1). There are coeliac patients for whom gluten would be detrimental, as studies show histological abnormalities with moderate (200-1000mg/day) intakes (19). There is also overwhelming evidence that a GFD might be beneficial in coeliac patients presenting with microscopic lesions (15, 20, 21). In an ideal world our aim should be to identify cases with different tolerance for gluten based on future accurate tests as gluten tolerance might be variable between different individuals (5). Hopefully by developing sensitive marker in future we may achieve the goal to lessening the degree of gluten restriction in suitable candidate and improve the quality of life in those patients with a higher threshold for gluten toxicity.


Gluten tolerance; potential challenges in treatment strategies.

Bold J, Rostami K - Gastroenterol Hepatol Bed Bench (2011)

Gluten free diet guide. * The subgroup with a potential higher gluten tolerance need to be defined in future studies.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4017406&req=5

Figure 0001: Gluten free diet guide. * The subgroup with a potential higher gluten tolerance need to be defined in future studies.
Mentions: When presentation is atypical, it can be a challenge to identify a patient where a GFD may be of benefit. Similarly, identification of the subgroups that may need less restriction with their gluten intake could also be extremely difficult (Figure 1). There are coeliac patients for whom gluten would be detrimental, as studies show histological abnormalities with moderate (200-1000mg/day) intakes (19). There is also overwhelming evidence that a GFD might be beneficial in coeliac patients presenting with microscopic lesions (15, 20, 21). In an ideal world our aim should be to identify cases with different tolerance for gluten based on future accurate tests as gluten tolerance might be variable between different individuals (5). Hopefully by developing sensitive marker in future we may achieve the goal to lessening the degree of gluten restriction in suitable candidate and improve the quality of life in those patients with a higher threshold for gluten toxicity.

Bottom Line: It is estimated that daily consumption of gluten from contaminated gluten free foods is in the range of 5 to 50 mg.Conversely, it seems there is evidence that some patients might have a much lower threshold for gluten.Whatever would be the individual threshold, GFD may be of benefit to any symptomatic patients even those with milder enteropathy like microscopic enteritis.

View Article: PubMed Central - PubMed

Affiliation: Institute of Health, Social Care and Psychology University of Worcester UK.

ABSTRACT
Tolerable gluten thresholds in gluten free products have long been debated together with issues of cross contamination of gluten free cereals during the milling process. It is well established that a totally gluten free diet is virtually impossible owing to the presence of traces of gluten. It is estimated that daily consumption of gluten from contaminated gluten free foods is in the range of 5 to 50 mg. We believe evidence is mounting that it may be possible for some coeliac patients to tolerate gluten above the limits considered permissible at threshold levels. Conversely, it seems there is evidence that some patients might have a much lower threshold for gluten. Whatever would be the individual threshold, GFD may be of benefit to any symptomatic patients even those with milder enteropathy like microscopic enteritis.

No MeSH data available.


Related in: MedlinePlus