Advances in the pathophysiology, diagnosis, and management of celiac disease.

Abstract

Celiac disease is an immune mediated disorder characterized by the loss of tolerance to ingested gluten in genetically susceptible individuals. Celiac disease affects approximately 1% of the global population and is associated with an increased risk of cancer and death. Celiac disease remains underdiagnosed owing to its heterogeneous clinical presentation, which includes intestinal and extra-intestinal symptoms in children and adults. People without symptoms who are in high risk groups, such as those with certain autoimmune conditions or first degree relatives with celiac disease, should be considered for screening. Whether the general population should be mass screened for celiac disease remains an area of active debate. Although a strict gluten-free diet is the current treatment for celiac disease, dozens of drug therapies in clinical development may radically shift the current paradigm of patient care. This review will cover the epidemiology, pathophysiology, diagnosis, and management of celiac disease, with a focus on recent advances in celiac related patient care and research.