Celiac Patients Need to Stay on Gluten Free Diet
Dig Liver Dis. 2010 Oct;42(10):685-91. Epub 2010 Apr 15.
Long-term deterioration of quality of life in adult patients with celiac disease is associated with treatment noncompliance.
Small Bowel Section, Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires, Argentina.
BACKGROUND: Deterioration of quality of life in the long term has been suggested for celiac disease patients on a gluten-free diet.
AIMS: To determine long-term quality of life of celiac disease patients and to assess the benefits of gluten-free diet compliance.
PATIENTS: We prospectively evaluated 53 newly diagnosed adult celiac disease patients.
METHODS: The Short Form 36 Health Survey, the Gastrointestinal Symptoms Rating Scale and the Beck Depression Inventory were employed at the time of diagnosis, 1 year, and beyond 4 years (median: 53 months) on treatment.
RESULTS: At 1 year, a significant improvement from baseline in quality of life indicators was observed (p<0.001 to p<0.0001) with comparable scores to healthy subjects. At 4 years, the Short Form 36 Health Survey scores (p<0.002 to p<0.0002) and Beck Depression Inventory score (p<0.002) show significant deterioration compare with 1 year. Most scores remained significantly better than those at diagnosis (p<0.03 to p<0.0005). No changes were detected in the Gastrointestinal Symptoms Rating Scale scores. The long-term impairment of quality of life was attributable to the deterioration of most dimensions in patients who were not strictly compliant with the gluten-free diet (p<0.05 to p<0.001).
CONCLUSIONS: Long-term deterioration of quality of life outcomes after the first year of gluten-free diet was associated with the lack of strict compliance with the diet.