failure to respond to treatment

Last reviewed 01/2018

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