After 12 months on a gluten-free diet (GFD), patients with non-responsive celiac disease (NRCD) still exhibit symptoms and enteropathy (Marsh 3 histology) indicative of active celiac disease (CeD). Only 15% of kids with CeD may have NRCD, but researchers don’t have enough data to say for sure, and there’s been no research done so far on how to treat kids with NRCD. This research set out to document how scientists here at the center diagnose and treat NRCD with budesonide and the Gluten Containing Elimination Diet (GCED).

Patients with CD younger than 18 years old (inclusive) who were treated for persistent symptoms and enteropathy despite adhering to a GFD were the focus of a 5-year retrospective single-center study. About 22 people were found to have NRCD. After 3 months of GCED therapy, 46% of the original 13 patients showed improvement in both histological and symptomatic measures. Treatment with budesonide (6-9 mg) was effective for 9 patients, with 89% showing improvement in symptoms and 83% showing improvement in histology after a median of 3 months.

In addition, after switching back to exclusive GFD, 67% of patients who responded to the GCED and 100% of patients who responded to budesonide stayed in remission for at least 6 months. As with NRCD, both GCED and budesonide have shown usefulness. Within 3 months of treatment, most people with NRCD can resume a GFD.