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Difficulty of the patient in the permanence of the celiac disease treatment: a literary review

Gastroenterology & Hepatology: Open Access
Jeane Gomes da Silva,1 Narah Berthyse Barbosa,2 Juliany da Costa Estral Mosquini,1 Isabeli Maria Mansano Pardi,1 Pérola Fernandes Ribeiro de Carvalho,1 Luiz Carlos Barreiros Medeiros,1 Andréia da Silva Costa,1 Nathália Lima Souza,1 Nicolas Pereira de Brito,1 Brian França dos Santos,3 Cleber Queiroz Leite1


Objective: Bibliographically analyze the challenges, importance and difficulties of adherence to treatment in individuals with celiac disease. Bibliographic review: Celiac disease (CD) is an autoimmune disease due to intolerance to gluten, which makes it difficult for the body to absorb nutrients and water. CD has a prevalence of up to 1% of the world’s population, of which approximately 300,000 Brazilians are carriers. The pathophysiology of CD occurs by an inflammatory activation that occurs mainly by immunological processes mediated by T cells, damaging the microvilli and leaving the intestine with a smooth appearance. Due to the inflammatory process, the classic picture of malabsorption generates symptoms that include diarrhea, steatorrhea and lack of appetite, as well as extra intestinal manifestations that include dermatitis, malnutrition, pubertal delay and others. Currently, it is understood that there are not many treatment options for CD, since the gluten-free diet is the only one that is effective for these patients. Therefore, adherence to such therapy is not so simple, since there are a number of social and economic difficulties that hinder this process. Final considerations: Although CD has a simple therapeutic option, it involves several intercurrences which impair adherence to treatment and can cause consequences for celiac patients. That said, promoting access to information about CD is important not only for celiac patients, but also for the general population in order to facilitate better and simplified access to gluten-free products


CD, Celiac disease, HLA, histocompatibility molecules, APCs, antigen presenting molecules, ACELBRA, according to the Brazilian celiac association of Brazil