Going Beyond Gluten-Free.

Celiac disease (CD) is an autoimmune, small intestinal enteropathy caused by a permanent sensitivity to gluten from wheat, rye, and barley in genetically susceptible individuals. Affecting ∼1% of children, 1 CD is more common than sickle cell disease or type 1 diabetes mellitus. The prevalence of CD continues to increase, partially due to increasing clinical and public awareness. 2 Even so, it is believed that a large majority of patients remain undiagnosed. Young children often present with gastrointestinal symptoms such as bloating, diarrhea, abdominal pain, and failure to thrive, whereas older children and adolescents are more likely to present with poor growth and extraintestinal symptoms such as anemia and delayed puberty. 3 Once diagnosed, treatment requires lifelong adherence to a strict gluten-free diet and failure to do so places patients at risk of multiple health concerns, including suboptimal growth, progressive osteoporosis, enteropathy-associated T-cell lymphoma, and shortened life expectancy. 3, 4 Thus, timely diagnosis and treatment, with regular follow-up to ensure compliance, are essential for the long-term health and well-being of all who have CD.