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Nutrients. 2016 Jul 14;8(7). pii: E429. doi: 10.3390/nu8070429.

Gastrointestinal Symptoms in Celiac Disease Patients on a Long-Term Gluten-Free Diet.

Author information

1
School of Medicine, University of Tampere, Tampere 33014, Finland. laurikka.pilvi.l@student.uta.fi.
2
School of Medicine, University of Tampere, Tampere 33014, Finland. teea.salmi@uta.fi.
3
Department of Dermatology, Tampere University Hospital, Tampere 33014, Finland. teea.salmi@uta.fi.
4
School of Medicine, University of Tampere, Tampere 33014, Finland. pekka.collin@uta.fi.
5
Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, University of Tampere, Tampere 33014, Finland. pekka.collin@uta.fi.
6
Tampere School of Health Sciences, University of Tampere, Tampere 33014, Finland. heini.huhtala@staff.uta.fi.
7
Centre for Child Health Research, University of Tampere and Tampere University Hospital, Tampere 33014, Finland. markku.maki@uta.fi.
8
School of Medicine, University of Tampere, Tampere 33014, Finland. markku.maki@uta.fi.
9
Department of Internal Medicine, Tampere University Hospital, Tampere 33014, Finland. markku.maki@uta.fi.
10
Centre for Child Health Research, University of Tampere and Tampere University Hospital, Tampere 33014, Finland. kalle.kurppa@uta.fi.

Abstract

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.

KEYWORDS:

celiac disease; gastrointestinal diseases; gluten-free diet; symptoms

PMID:
27428994
PMCID:
PMC4963905
DOI:
10.3390/nu8070429
[Indexed for MEDLINE]
Free PMC Article

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