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Medicina interna de México
versión impresa ISSN 0186-4866
Resumen
COBOS-QUEVEDO, O; HERNANDEZ-HERNANDEZ, GA y REMES-TROCHE, JM. Gluten-related disorders: Current state. Med. interna Méx. [online]. 2017, vol.33, n.4, pp.487-502. ISSN 0186-4866.
Wheat is one of the most produced and consumed cereals worldwide because of its simplicity to be cultivated in different climatic conditions, its nutritional value and its organoleptic characteristics. Wheat, as barley and rye, contains a molecule which can potentially be toxic to some individuals, the gluten. Today gluten-related disorders represent a diagnostic and therapeutic challenge as they include diseases that can have complications and deleterious health effects such as celiac disease, to purely symptomatic situations such as non-celiac gluten sensitivity (NGCS). A high clinical suspicion, as well as knowledge in the interpretation of diagnostic tests (serology, biopsy and genetic testing) are required to have an appropriate approach. In Mexico it is estimated that 1% of the population suffers celiac disease, 0.7% wheat allergy and NGCS can vary from 1% to 25% in special populations (irritable bowel syndrome, dyspepsia). At present proven celiac disease patients must undergo a strict gluten-free diet for the potential risk of complications. On the other hand in patients with NGCS, although this type of diet is recommended, lack of adherence will only lead to symptomatic relapse. Moreover, although there is a great availability of gluten free diets and products, these are not recommended for the general population or in cases in who the diagnosis of some of the gluten-related disorders is not properly established.
Palabras llave : wheat; gluten sensitivity; allergy; celiac disease.