Gastrointestinal symptoms and quality of life in screen-detected celiac disease.
BACKGROUND
Active serological screening has proved an effective means of increasing the diagnostic rate in celiac disease. The effects of a long-term gluten-free diet on possible gastrointestinal symptoms and psychological well-being in screen-detected patients have nevertheless remained obscure.


METHODS
Abdominal symptoms and quality of life were measured in a large cohort of treated screen-detected celiac adults. Comparisons were made with corresponding symptom-detected patients and with non-celiac controls. Dietary adherence was assessed both by structured interview and by serological testing.


RESULTS
In both screen- and symptom-detected celiac groups, 88% of the patients were adherent. On a diet, both screen- and symptom-detected patients reported significantly more gastrointestinal symptoms than non-celiac controls. Those screen-detected patients who reported having no symptoms at the time of diagnosis, also remained asymptomatic during the diet. Despite persistent symptoms, psychological well-being in screen-detected patients was comparable with that in non-celiac controls, whereas the symptom-detected patients showed lower quality of life.


CONCLUSIONS
Long-term treated screen-detected celiac patients, especially women, suffer from gastrointestinal symptoms on a gluten free diet similarly to symptom-detected patients. However, despite a similar frequency of persistent symptoms, the quality of life was unimpaired in the screen found, but remained low in the symptom-detected group.
School of Medicine, University of Tampere, Tampere, Finland.
Aku
A
Paavola
Kalle
K
Kurppa
Anniina
A
Ukkola
Pekka
P
Collin
Marja-Leena
ML
Lähdeaho
Heini
H
Huhtala
Markku
M
Mäki
Katri
K
Kaukinen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy / Q000523:psychology; D055050:Diet, Gluten-Free; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010349:Patient Compliance; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult