Editorial
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 21, 2017; 23(15): 2635-2639
Published online Apr 21, 2017. doi: 10.3748/wjg.v23.i15.2635
Dietary compliance in celiac disease
Hugh James Freeman
Hugh James Freeman, Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, BC V6T 1Z4, Canada
Author contributions: Freeman HJ solely contributed to this paper.
Conflict-of-interest statement: The author has no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Hugh James Freeman, Professor, Department of Medicine (Gastroenterology), University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 1Z4, Canada. hugfree@shaw.cac
Telephone: +1-604-8227216
Received: December 30, 2016
Peer-review started: January 3, 2017
First decision: January 19, 2017
Revised: January 24, 2017
Accepted: March 20, 2017
Article in press: March 20, 2017
Published online: April 21, 2017
Processing time: 111 Days and 11.5 Hours
Core Tip

Core tip: Celiac disease is an immune-mediated disorder that improves with a strict gluten-free diet. Dietary compliance is essential for symptom resolution and reduction of the risk of long-term complications, including malignancy. Recent evidence suggests that resolution of symptoms and normalization of serological antibody markers on a gluten-free diet occurs, but mucosal inflammatory changes may persist, a critical risk factor for long-term complications. Several recent biopsy studies have documented that the small intestinal mucosa in adult celiac disease may completely normalize within months, but most require up to 2 years or more to demonstrate mucosal recovery and healing. Histopathological rates of resolution on a gluten-free diet appear to be time-dependent, sex-dependent with higher rates in females, and age-dependent, with lower rates in the very elderly.