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Iron deficiency occurs when dietary intake is insufficient, when absorption in the gastrointestinal tract is impaired, when demand is increased (accelerated growth, pregnancy), or as a consequence of blood loss

Gliadin induced release of zonulin by binding to CXCR3 and elevated permeability ex vivo in biopsies of healthy volunteers and patients with quiescent CeD (90, 91)

Not surprisingly, some genetic factors may contribute to weakness of the diaphragm or loosen the phrenoesophageal ligament, which attaches the esophagus to the diaphragm