Is ‘Gluten-Free’ Gluten-Free? Celiac Disease in Canada in 2015

Our understanding of celiac disease (CD) has improved dramatically in recent years. Once considered a rare childhood malabsorption syndrome, we now recognize CD as a complex enteropathy mediated by immune, genetic, and environmental factors. CD affects a large proportion of the Canadian population, and its disease burden is substantial in terms of proven reduction in quality of life. Symptom recognition and referral to a gastroenterologist for diagnosis are crucial. As CD is caused by intolerance to gluten, the only effective treatment is strict gluten avoidance. Canadian food product guidelines have only recently become sufficiently rigid, incorporating newer evidence that suggests lower limits of gluten tolerability in this patient population than previously thought.