title: Gastrointestinal symptoms and well-being of adults living on a gluten-free diet: a case for nursing in celiac disease.
abstract: Women with celiac disease (CD) living on a gluten-free diet (GFD) show a lower health-related quality of life and report a higher rate of gastrointestinal (GI) symptoms than men with CD. Uncertainty exists as to whether GI symptoms may explain the poorer treatment outcome of women with CD. This study was designed to explore relationships of GI symptoms and psychological well-being in men and women with long-standing CD. Patients with CD (n = 108; 59% women), aged 45-64 years, treated with a GFD for at least 8 years were evaluated by the Gastrointestinal Symptom Rating Scale and the Psychological General Well-Being index. The results show that women with a high rate of GI symptoms have no lower level of psychological well-being than corresponding men with CD and that women with CD with reduced psychological well-being have no more GI symptoms than corresponding men. Our results fail to support the notion that the reduced subjective health in CD is explained by GI symptoms. They may be secondary to perceived difficulties in managing everyday life, suggesting that launching a nurse-led follow-up may be helpful, as has been proven to be useful in other lifelong disorders.
authors.affiliation: Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Norrköping, Sweden. susro@isv.liu.se
authors.forename: Susanne
authors.initials: S
authors.lastname: Roos
authors.forename: Anita
authors.initials: A
authors.lastname: Kärner
authors.forename: Claes
authors.initials: C
authors.lastname: Hallert
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D002446:Celiac Disease / Q000178:diet therapy / Q000451:nursing* / Q000523:psychology*; D015331:Cohort Studies; D055050:Diet, Gluten-Free; D005260:Female; D005767:Gastrointestinal Diseases / Q000503:physiopathology; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D018434:Sickness Impact Profile