Background
Celiac disease (CeD) is an immune-mediated enteropathy triggered by the ingestion of gluten in genetically susceptible individuals. It affects approximately 1% of the global population, though many cases remain undiagnosed. The cornerstone of management is a strict, lifelong gluten-free diet (GFD), which is the only established treatment currently available. Adherence to a GFD is challenging not only because gluten is ubiquitous in the Western diet but also because patients must navigate social interactions, dining out, and intimate situations where inadvertent gluten exposure may occur.
One area of particular concern among patients with celiac disease—and one that clinicians have historically lacked data to address—is the potential for gluten transfer through intimate contact, specifically kissing. Patients frequently express anxiety about whether a kiss from a partner who has recently consumed gluten-containing foods could introduce sufficient gluten to provoke an immune response. This concern is not trivial; even trace amounts of gluten can trigger intestinal inflammation and symptom recurrence in sensitive individuals, and cumulative low-level exposure may contribute to persistent mucosal damage despite apparent dietary adherence.
