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Patients with RCD may never have responded to a GFD or may have relapsed despite adherence and initial response to the GFD. RCD type 1 usually improves after treatment with a combination of aggressive nutritional support, adherence to a GFD, and alternative pharmacological therapies. By contrast, clinical response to alternative therapies in RCD type 2 is less certain and the prognosis is poor. Severe complications such as ulcerative jejunitis and enteropathy-associated T cell lymphoma may occur in a subgroup of patients with RCD. The aims of this article are to (1) review recent advances in the diagnosis and management of patients with RCD, and (2) describe current and novel methods for classification of patients with RCD into categories that are useful to predict outcome and direct treatment.<\/jats:p>","DOI":"10.1136\/gut.2009.195131","type":"journal-article","created":{"date-parts":[[2010,3,23]],"date-time":"2010-03-23T23:04:42Z","timestamp":1269385482000},"page":"547-557","source":"Crossref","is-referenced-by-count":282,"title":["Classification and management of refractory coeliac disease"],"prefix":"10.1136","volume":"59","author":[{"given":"Alberto","family":"Rubio-Tapia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph 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