Elemental diet in the treatment of refractory coeliac disease

A minority of patients with coeliac disease do not improve in spite of strictly adhering to gluten-free diet and are considered to have developed refractory disease. Such patients are usually treated with steroid and/or immunosuppressive agents but these are not without serious side effects. Herein, we present a patient with refractory coeliac disease in whom remarkable clinical and histological improvement was achieved on elemental diet. Elemental diet should be considered as a treatment option in such patients.