TABLE 2.
Potential causes of non‐responsive coeliac disease
| Persistent symptoms |
| Wrong diagnosis |
| Ongoing gluten ingestion |
| Irritable bowel syndrome and FODMAP intolerance, e.g lactose or fructans |
| Microscopic colitis |
| Small intestinal bacterial overgrowth |
| Pancreatic insufficiency |
| Other gastrointestinal disorders, e.g. Inflammatory bowel disease |
| Refractory coeliac disease |
| Lymphoma |
| Persistent enteropathy |
| Slowly responsive disease |
| Ongoing gluten ingestion |
| Medications associated with delayed healing: proton pump inhibitors, non‐steroidal anti‐inflammatory drugs and selective serotonin reuptake inhibitors |
| Wrong diagnosis |
| Other causes for the enteropathy |
| Immune |
| Common Variable Immunodeficiency |
| Cow’s Milk Protein Intolerance |
| Autoimmune enteropathy |
| Immune dysregulation‐related enteropathy |
| Crohn’s disease |
| Collagenous sprue |
| Graft versus host disease |
| Infective |
| Helicobacter pylori |
| Giardia lambla |
| Tropical sprue |
| Small intestinal bacterial overgrowth |
| Viral, e.g. norovirus, HIV |
| Whipple’s disease |
| Medications |
| Angiotensin receptor blocker (sartans) |
| Immune checkpoint inhibitors |
| Methotrexate |
| Mycophenolate |
| Non‐steroidal anti‐inflammatory drugs |
| Refractory coeliac disease |
| Wrong diagnosis |