Gastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet.
OBJECTIVE
Celiac disease (CD) patients often complain of symptoms consistent with gastroesophageal reflux disease (GERD). We aimed to assess the prevalence of GERD symptoms at diagnosis and to determine the impact of the gluten-free diet (GFD).


METHODS
We evaluated 133 adult CD patients at diagnosis and 70 healthy controls. Fifty-three patients completed questionnaires every 3 months during the first year and more than 4 years after diagnosis. GERD symptoms were evaluated using a subdimension of the Gastrointestinal Symptoms Rating Scale for heartburn and regurgitation domains.


RESULTS
At diagnosis, celiac patients had a significantly higher reflux symptom mean score than healthy controls (P < .001). At baseline, 30.1% of CD patients had moderate to severe GERD (score >3) compared with 5.7% of controls (P < .01). Moderate to severe symptoms were significantly associated with the classical clinical presentation of CD (35.0%) compared with atypical/silent cases (15.2%; P < .03). A rapid improvement was evidenced at 3 months after initial treatment with a GFD (P < .0001) with reflux scores comparable to healthy controls from this time point onward.


CONCLUSIONS
GERD symptoms are common in classically symptomatic untreated CD patients. The GFD is associated with a rapid and persistent improvement in reflux symptoms that resembles the healthy population.
Nachman
Fabio
F
Department of Medicine, Dr C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires, Argentina.
Vázquez
Horacio
H
González
Andrea
A
Andrenacci
Paola
P
Compagni
Liliana
L
Reyes
Hugo
H
Sugai
Emilia
E
Moreno
María Laura
ML
Smecuol
Edgardo
E
Hwang
Hui Jer
HJ
Sánchez
Inés Pinto
IP
Mauriño
Eduardo
E
Bai
Julio César
JC
D000293:Adolescent; D000328:Adult; D000368:Aged; D002446:Celiac Disease / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D055050:Diet, Gluten-Free; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult