Most Celiac Patients Improve on a Long-Term Gluten-Free Diet

Celiac.com 08/22/2016 - Many doctors hear from celiac patients who suffer from persistent symptoms despite a long-term gluten-free diet. A research team recently set out to investigate the prevalence and severity of these symptoms in patients with variable duration of a gluten-free diet.

The research team included Pilvi Laurikka, Teea Salmi, Pekka Collin, Heini Huhtala, Markku Mäki, Katri Kaukinen, and Kalle Kurppa. They are variously affiliated with the School of Medicine, University of Tampere, Tampere 33014, Finland, the Department of Internal Medicine, the Department of Dermatology, the Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, University of Tampere, Tampere 33014, Finland, and the Tampere School of Health Sciences, at the University of Tampere in Tampere 33014, Finland, the Centre for Child Health Research at the University of Tampere and Tampere University Hospital, Tampere 33014, Finland.

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Altogether, the team classified 856 patients into three groups: 128 untreated patients, 93 on a short-term gluten-free diet of 1–2 years, and 635 patients on a long-term gluten-free diet of 3 years or longer. They conducted analyses of clinical and histological data and dietary adherence. They also included a control group of 166 healthy subjects.

The team evaluated symptoms according to the validated GSRS questionnaire. They compared severity of symptoms against severity in cases of 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 gluten-free diet and recovered mucosa. Untreated patients had more diarrhea, indigestion and abdominal pain than those on a gluten-free diet and controls.

Their results showed no differences in symptoms between the short- and long-term gluten-free diet groups, though both showed poorer GSRS total score than control subjects, with p = 0.03 and p = 0.05, respectively. Patients treated 1–2 years had more diarrhea (p = 0.03) and those treated >10 years had more cases of reflux (p = 0.04) than control subjects.

Meanwhile, long-term treated celiac patients showed relatively mild symptoms compared with other gastrointestinal diseases.

Based on these results, most celiac patients showed a good response to gluten-free diet, which continued in long-term follow-up, although not all patients see their health return to that of non-celiac individuals.

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