Gluten Intolerance and Sensitivityin the Elderly.

Abstract

Celiac disease (CD) is a chronic, immune-mediated enteropathy in genetically predisposed individuals caused by the ingestion of gluten-containing cereals. CD is further characterized by variable clinical presentation, specific serum autoantibody response and a variable degree of damage in the small intestinal mucosa. HLA molecules DQ2 (90%–95%) and DQ8 (5%–10%) are associated with CD, and in the continued presence of gluten the disease is self-perpetuating. Regarding clinical presentation, CD patients may complain of not only gastrointestinal (GI) symptoms, but also extraintestinal symptoms, and most importantly they may often be asymptomatic (“silent” CD). In recent years, several reports have suggested a major shift in the clinical presentation of CD with extraintestinal symptoms being more prevalent than “classical” GI symptoms. CD is also associated with several autoimmune diseases, usually thyroiditis and diabetes mellitus type 1. Currently, the only effective treatment available is a strict life-long gluten-free diet (GFD), which improves symptoms, nutritional status, and serologic and histologic changes