Rostami Adele, Hogg-Kollars Sabine
Digestive Health Clinic, Palmerston North New Zealand.
Department of Nutrition, University College of Teacher Education, Vienna, Austria.
Gastroenterol Hepatol Bed Bench. 2023;16(2):136-144. doi: 10.22037/ghfbb.v16i2.2807.
A substantial number of coeliac disease patients fail to respond to treatment with a gluten-free diet. Non-responsiveness might be multifactorial and the spectrum ranges from intentional or inadvertent gluten contamination as the main aetiology, to sensitivity to other nutrients (in addition to additives and preservatives). If the diagnosis of coeliac disease is correctly made and cross contamination and other factors have been excluded, then the aetiology behind the symptoms of a small group of coeliac patients might be refractory coeliac disease. The journey to ensure gluten contamination is not behind the persistent symptoms, is very challenging and requires in-depth training and skills. We therefore present potential guidance for the healthcare professional, in particular dietitians, on how to navigate these challenges on this journey.
相当一部分乳糜泻患者对无麸质饮食治疗没有反应。无反应可能是多因素的，范围从以故意或无意的麸质污染为主要病因，到对其他营养素（除添加剂和防腐剂外）敏感。如果乳糜泻的诊断正确无误，并且交叉污染和其他因素已被排除，那么一小部分乳糜泻患者症状背后的病因可能是难治性乳糜泻。要确定持续症状并非由麸质污染引起，这一过程极具挑战性，需要深入的培训和技能。因此，我们为医疗保健专业人员，尤其是营养师，提供关于如何在这一过程中应对这些挑战的潜在指导。
