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Failure to respond to treatment

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Failure to respond may be a result of:

  • dietary lapse - consultation with a dietician to discover whether the patient is eating (possibly unwittingly) any forbidden foods. If necessary anti-alpha-gliadin antibodies can be measured to monitor adherence to diet
  • exclude alcoholism, diabetes mellitus, hyperthyroidism
  • associated intolerence of lactose may be present - a trial milk-free diet should be undertaken
  • vitamin or mineral deficiency (Zn, Cu) should be excluded
  • malignancy - lymphoma should be excluded
  • other possible diagnoses should be considered:
    • chronic giardiasis (note history if pet owner)
    • concurrent pancreatic insufficiency
    • Zollinger-Ellison syndrome
    • bacterial overgrowth
    • AIDS complex

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