title: High rate of gastrointestinal symptoms in celiac patients living on a gluten-free diet: controlled study.
abstract: OBJECTIVE
  The aim of this study was to determine the occurrence of GI symptoms in adults with celiac disease (CD) treated with a gluten-free diet for several years.
  
  
  METHODS
  We studied a cohort of adults with CD (n = 51; 59% women) aged 45-64 yr and proved to be in remission after 8-12 yr of treatment. They were examined by the GI Symptom Rating Scale, which comprises five syndromes: indigestion, diarrhea, constipation, abdominal pain, and reflux. A general population sample (n = 182; 57% women) of same age served as controls.
  
  
  RESULTS
  Subjects with CD reported significantly more GI symptoms than the general population sample, as assessed by the GI Symptom Rating Scale total score (p < 0.01). This was particularly true for women with CD who scored worse than female controls for all syndromes on the GI Symptom Rating Scale. By contrast, the men with CD reported no more symptoms than male controls. The women with CD showed generally more complaints than the men with CD did, notably within indigestion, constipation, and abdominal pain, corresponding to a 2-fold higher rate of GI symptoms (60% vs 29%; p < 0.04).
  
  
  CONCLUSIONS
  Adult CD patients on a gluten-free diet for several years experienced significantly more GI symptoms than the general population sample. This may have some of its origin in the composition of a gluten-free diet. The symptoms were more pronounced in the women. This may raise questions of an association with their subjective health status, which has been shown to be lower than in men with CD.
mesh_terms: D017677:Age Distribution; D000368:Aged; D016022:Case-Control Studies; D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy*; D015331:Cohort Studies; D016001:Confidence Intervals; D018753:Diet, Protein-Restricted; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000209:etiology*; D005983:Glutens; D006801:Humans; D015994:Incidence; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D011336:Probability; D012016:Reference Values; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric
chemical_list: D005983:Glutens