Celiac disease: small-bowel enteroclysis findings in adult patients treated with a gluten-free diet.
OBJECTIVE
To correlate the radiologic, histopathologic, and clinical findings in patients with celiac disease after treatment with a glutenfree diet.


METHODS
Pretreatment and follow-up enteroclysis radiographs from 15 adult patients with known celiac disease were reviewed. Diagnosis of celiac disease was made at adult age. Changes in small-bowel morphology were determined by comparing enteroclysis findings before and after treatment with a gluten-free diet and were correlated with histopathologic and clinical findings.


RESULTS
Eight of 15 patients (group I) showed increased small-bowel abnormalities. All patients had increased symptoms, and all but one, whose condition had deteriorated, showed stable disease at biopsy. Group II patients (five of 15) showed improvement at follow-up enteroclysis. Biopsy findings showed improvement in small-bowel morphology in four patients and no change in one. Clinically, four patients showed improvement, and one had stable disease. Group III patients (two of 15) showed no change from initial to follow-up enteroclysis. Both showed partial atrophy, which was consistent with biopsy findings. In all patients, clinical symptoms correlated better with enteroclysis results (r = .48; P < .005) than they did with follow-up biopsy results (r = .18). True celiac disease-related malignancies and coexisting tumors occurred in 10 of 15 patients.


CONCLUSIONS
Enteroclysis appears to be more reliable than does biopsy in evaluation of response to a gluten-free diet in adults with celiac disease.
van den Bosch
H C
HC
Department of Diagnostic Radiology, Catharina Ziekenhuis, Eindhoven, The Netherlands.
Tjon a Tham
R T
RT
Gooszen
A W
AW
Fauquenot-Nollen
J M
JM
Lamers
C B
CB
D000328:Adult; D000368:Aged; D001284:Atrophy; D001466:Barium Sulfate / Q000008:administration & dosage; D002446:Celiac Disease / Q000000981:diagnostic imaging / Q000178:diet therapy / Q000473:pathology; D005500:Follow-Up Studies; D005983:Glutens / Q000008:administration & dosage*; D006801:Humans; D007422:Intestines / Q000473:pathology; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies
D001466:Barium Sulfate; D005983:Glutens