title: Gastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet.
abstract: 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.
authors.affiliation: Department of Medicine, Dr C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires, Argentina.
authors.forename: Fabio
authors.initials: F
authors.lastname: Nachman
authors.forename: Horacio
authors.initials: H
authors.lastname: Vázquez
authors.forename: Andrea
authors.initials: A
authors.lastname: González
authors.forename: Paola
authors.initials: P
authors.lastname: Andrenacci
authors.forename: Liliana
authors.initials: L
authors.lastname: Compagni
authors.forename: Hugo
authors.initials: H
authors.lastname: Reyes
authors.forename: Emilia
authors.initials: E
authors.lastname: Sugai
authors.forename: María Laura
authors.initials: ML
authors.lastname: Moreno
authors.forename: Edgardo
authors.initials: E
authors.lastname: Smecuol
authors.forename: Hui Jer
authors.initials: HJ
authors.lastname: Hwang
authors.forename: Inés Pinto
authors.initials: IP
authors.lastname: Sánchez
authors.forename: Eduardo
authors.initials: E
authors.lastname: Mauriño
authors.forename: Julio César
authors.initials: JC
authors.lastname: Bai
mesh_terms: 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