title: Gastrointestinal Symptoms in Celiac Disease Patients on a Long-Term Gluten-Free Diet.
abstract: Experience suggests that many celiac patients suffer from persistent symptoms despite a long-term gluten-free diet (GFD). We investigated the prevalence and severity of these symptoms in patients with variable duration of GFD. Altogether, 856 patients were classified into untreated (n = 128), short-term GFD (1-2 years, n = 93) and long-term GFD (≥3 years, n = 635) groups. Analyses were made of clinical and histological data and dietary adherence. Symptoms were evaluated by the validated GSRS questionnaire. One-hundred-sixty healthy subjects comprised the control group. Further, the severity of symptoms was compared with that in peptic ulcer, reflux disease, inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). Altogether, 93% of the short-term and 94% of the long-term treated patients had a strict GFD and recovered mucosa. Untreated patients had more diarrhea, indigestion and abdominal pain than those on GFD and controls. There were no differences in symptoms between the short- and long-term GFD groups, but both yielded poorer GSRS total score than controls (p = 0.03 and p = 0.05, respectively). Furthermore, patients treated 1-2 years had more diarrhea (p = 0.03) and those treated >10 years more reflux (p = 0.04) than controls. Long-term treated celiac patients showed relatively mild symptoms compared with other gastrointestinal diseases. Based on our results, good response to GFD sustained in long-term follow-up, but not all patients reach the level of healthy individuals.
authors.affiliation: School of Medicine, University of Tampere, Tampere 33014, Finland. laurikka.pilvi.l@student.uta.fi.
authors.forename: Pilvi
authors.initials: P
authors.lastname: Laurikka
authors.affiliation: School of Medicine, University of Tampere, Tampere 33014, Finland. teea.salmi@uta.fi.|Department of Dermatology, Tampere University Hospital, Tampere 33014, Finland. teea.salmi@uta.fi.
authors.forename: Teea
authors.initials: T
authors.lastname: Salmi
authors.affiliation: School of Medicine, University of Tampere, Tampere 33014, Finland. pekka.collin@uta.fi.|Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, University of Tampere, Tampere 33014, Finland. pekka.collin@uta.fi.
authors.forename: Pekka
authors.initials: P
authors.lastname: Collin
authors.affiliation: Tampere School of Health Sciences, University of Tampere, Tampere 33014, Finland. heini.huhtala@staff.uta.fi.
authors.forename: Heini
authors.initials: H
authors.lastname: Huhtala
authors.affiliation: Centre for Child Health Research, University of Tampere and Tampere University Hospital, Tampere 33014, Finland. markku.maki@uta.fi.
authors.forename: Markku
authors.initials: M
authors.lastname: Mäki
authors.affiliation: School of Medicine, University of Tampere, Tampere 33014, Finland. markku.maki@uta.fi.|Department of Internal Medicine, Tampere University Hospital, Tampere 33014, Finland. markku.maki@uta.fi.
authors.forename: Katri
authors.initials: K
authors.lastname: Kaukinen
authors.affiliation: Centre for Child Health Research, University of Tampere and Tampere University Hospital, Tampere 33014, Finland. kalle.kurppa@uta.fi.
authors.forename: Kalle
authors.initials: K
authors.lastname: Kurppa
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology / Q000517:prevention & control; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology / Q000517:prevention & control; D055050:Diet, Gluten-Free; D004415:Dyspepsia / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005387:Finland / Q000453:epidemiology; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications; D043183:Irritable Bowel Syndrome / Q000150:complications; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010437:Peptic Ulcer / Q000150:complications; D015995:Prevalence; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: celiac disease; gastrointestinal diseases; gluten-free diet; symptoms