Celiac Disease and Non-Celiac Gluten Sensitivity

Book excerpt: Celiac disease is a systemic autoimmune process and appears in genetically predisposed individuals, with a well-known cause, consisting in a permanent intolerance to gluten, a protein contained in the flour of wheat, rye, barley and oats. Worldwide celiac disease affects to 1% of the Caucasian and there is recent evidence that the disease is increasing in USA and Finland among other regions in the world. It is considered to be the most prevalent disease with a genetic predisposition. The clinical forms of presentation are varied. The classical form consisting of diarrhea, anemia and failure to thrive is still common in children, but in the adult patients the symptoms resemble the irritable bowel syndrome. Mono-symptomatic forms with extra-intestinal manifestations are frequent. Hematological, cutaneous, articular, hepatic, bone and neurological manifestations are often described. This protean presentation and the lack of awareness explain the delay in diagnosis and suggest that screening in high-risk groups is indicated. The publication of this book written mainly by Spanish and Latin-American clinicians, researchers, and teachers, demonstrates the wide interest and the involvement of different disciplines that are necessary to understand celiac disease and gluten-related pathologies, such as non-celiac gluten-sensitivity. This has a great impact in the general public and in the industry. However, the knowledge of non-celiac gluten-related pathologies remains scarce but presently in the process of being properly defined. This book also highlights the importance of recognizing non-celiac gluten-sensitivity and briefly discusses a new definition. It also provides some perspectives to take into account when studying celiac disease in China and Central America. It describes new observations in Mexico, El Salvador and Costa Rica. The psychosocial impact as studied and reported by Argentinean investigators also adds to the value of this book. Written with a multidisciplinary team, we think that this book could be of interest to a great variety of medical specialists. Due to the systemic nature and variable presentation of celiac disease it certainly is of interest to pediatricians, gastroenterologists, hepatologists, specialists in internal medicine, general practitioners as well as hematologists, immunologists, geneticists, pathologists, rheumatologists, dermatologists, neurologists, gynecologists, neurologists, psychiatrists, psychologists, orthopedic surgeons, specialists in rehabilitation medicine, endocrinologists. Being gluten the cause of these disorders, the food industry, dietitians and nutritionists will benefit from the valuable information presented in this book.