Gastrointestinal Symptoms in Celiac Disease Patients on a Long-Term Gluten-Free Diet.
Study Goal
The researchers aimed to investigate the prevalence and severity of persistent symptoms in celiac patients on a gluten-free diet (GFD) with varying durations of adherence.
Results Summary
Most patients on GFD showed strict adherence and mucosal recovery, but symptoms persisted at higher levels than healthy controls. Long-term GFD patients had relatively mild symptoms compared to other gastrointestinal diseases, though not all reached the health level of controls.
Population
Celiac patients (untreated, short-term GFD [1-2 years], long-term GFD [≥3 years]) and healthy controls.
Effective Dosage
Not specified
Duration
Variable (1-2 years for short-term, ≥3 years for long-term)
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
long-term gluten-free diet | no change | symptoms | many celiac patients | - | suffer from persistent symptoms despite | #1 |
gluten-free diet | increase | mucosa | 93% of the short-term and 94% of the long-term treated patients | - | had a strict GFD and recovered mucosa | #2 |
- | increase | diarrhea, indigestion and abdominal pain | untreated patients | - | had more diarrhea, indigestion and abdominal pain than | #3 |
gluten-free diet | increase | GSRS total score | short- and long-term GFD groups | - | yielded poorer GSRS total score than | #4 |
gluten-free diet (1-2 years) | increase | diarrhea | patients treated 1-2 years | - | had more diarrhea than | #5 |
gluten-free diet (>10 years) | increase | reflux | patients treated >10 years | - | had more reflux than | #6 |
long-term gluten-free diet | decrease | symptoms | long-term treated celiac patients | - | showed relatively mild symptoms compared with | #7 |
gluten-free diet | increase | response | patients | - | good response to GFD sustained in long-term follow-up | #8 |
gluten-free diet | no change | level of healthy individuals | patients | - | not all patients reach the level of | #9 |
Experience suggests that many celiac patients suffer from persistent symptoms despite a long-term gluten-free diet (GFD). We investigated the prevalence and severity of these symptoms in patients with variable duration of GFD. Altogether, 856 patients were classified into untreated (n = 128), short-term GFD (1-2 years, n = 93) and long-term GFD (≥3 years, n = 635) groups. Analyses were made of clinical and histological data and dietary adherence. Symptoms were evaluated by the validated GSRS questionnaire. One-hundred-sixty healthy subjects comprised the control group. Further, the severity of symptoms was compared with that in peptic ulcer, reflux disease, inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). Altogether, 93% of the short-term and 94% of the long-term treated patients had a strict GFD and recovered mucosa. Untreated patients had more diarrhea, indigestion and abdominal pain than those on GFD and controls. There were no differences in symptoms between the short- and long-term GFD groups, but both yielded poorer GSRS total score than controls (p = 0.03 and p = 0.05, respectively). Furthermore, patients treated 1-2 years had more diarrhea (p = 0.03) and those treated >10 years more reflux (p = 0.04) than controls. Long-term treated celiac patients showed relatively mild symptoms compared with other gastrointestinal diseases. Based on our results, good response to GFD sustained in long-term follow-up, but not all patients reach the level of healthy individuals.