Celiac.com 11/15/2008 - Managing celiac disease can be challenging in the best of circumstances, so imagine the frustration of experiencing on-going gastro-intestinal symptoms even while following a gluten free diet. Such frustration is increasingly common among people with celiac disease.
With increasing frequency, doctors worldwide are finding persistent villous atrophy in celiac patients who are following a gluten-free diet. Results of a study published recently in the Scandinavian Journal of Gastroenterology indicate that persistent intestinal villous atrophy in celiac disease patients on a gluten-free diet is associated with gastrointestinal symptoms considered 'atypical' for celiac disease and which are different from those present at the original celiac disease diagnosis.
Group I showed higher numbers of persistent endoscopic lesions compared with the control group. In fact, 35 patients (85%) from group I showed villous atrophy compared to just 9 (33%) of the control group.
The team noted that the gastrointestinal symptoms experienced by group I differed from those present at the time of their celiac disease diagnosis. 6 patients from group I experienced anemia/diarrhea/weight loss, while 12 experienced symptoms similar to gastroesophageal reflux disease, and 24 patients experienced abdominal pain and/or constipation.
Among the patients from group I, there was no difference in gender distribution, age and duration of gluten-free diet between those with normal villi and those with persistent partial villous atrophy, though the patients with persistent symptoms showed higher intraepithelial eosinophil counts than the asymptomatic patients.
These findings speak to the importance of developing protocols to monitor the progress of celiac patients over the long term. Until such protocols are developed, it is important that people with celiac disease pay close attention to any symptoms that may be celiac-related, and report those symptoms to their health care professionals at the earliest signs of trouble.
Scandinavian Journal of Gastroenterology; 2008: 43(11): 1315-21