Analysis of methods for assessing adherence to a gluten-free diet in children with celiac disease

Celiac disease is a chronic, multisystem autoimmune genetically determined disease associated with persistent gluten intolerance with the development of atrophic enteropathy. The basis of celiac disease treatment is adherence to a strict lifelong gluten-free diet, which leads to complete recovery of the intestinal mucosa and reduces the risk of possible complications of celiac disease, such as osteoporosis, intestinal lymphoma, cardiovascular disease and infertility. However, with increasing duration of the disease and duration of nutritional therapy, adherence to a strict gluten-free diet becomes more difficult, due not only to the accidental consumption of gluten-containing foods, but also to difficulties in recognizing sources of “hidden” gluten. It is necessary to monitor patients' adherence to diet as the only available treatment option for the disease. This article presents modern methods of assessing patients' adherence to a gluten-free diet based on dietary counseling, clinical evaluation, questionnaires, serologic and morphologic studies, and detection of gluten immunogenic peptides in human biological fluids. Key words: gluten-free diet, children, dietitian, questionnaire, adherence, celiac disease