Celiac Disease. It means that the patient is still experiencing symptoms and side effects of the celiac disease despite disease modifying changes in diet (avoidance of gluten), lifestyle and possibly medication.
Therapy not working. The treatment for celiac disease is a gluten-free diet. Refractory celiac disease is when a patient still has symptoms after being on a strictly gluten-free diet for one year. The patient may or may not have initially improved on the diet.