Abstract
Whilst most individuals will display improvement in symptoms and signs of coeliac disease following institution of the GFD, up to 30% will continue to experience symptoms and/ or have persisting intestinal inflammation. These individuals can be classified as having nonresponsive coeliac disease (NRCD), which can be the result of dietary indiscretion, gluten supersensitivity, slow healing, or an alternative condition initially masquerading as persistent coeliac disease. Individuals with coeliac disease are also at risk of developing serious complications, including refractory coeliac disease, ulcerative jejunitis and small bowel malignancies, which are typically classified together as complicated coeliac disease (CCD). The aim of this chapter is to provide an overview of the causes of NRCD and CCD and highlight a clinical approach to the patient with NRCD/ CCD.
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