Health Quality Of Life

[DrMom]

HRQoL impaired in celiac patients despite GFD adherence

07 July 2006

Eur J Gastroenterol Hepatol 2006; 18: 747-754

Despite adherence to a gluten-free diet (GFD), the majority of German celiac disease patients still experience a significant number of general and extra-intestinal symptoms, and a reduced health-related quality of life (HRQoL), researchers say.

Although there is a high prevalence of celiac disease in Europe, only a small number of studies on HRQoL have been conducted using validated instruments with clinical samples, the scientists state.

To address this imbalance, the team questioned 446 patients with biopsy-proven celiac disease. The participants were aged an average of 46 years and 78% were female.

Questionnaire data indicated that 67% of individuals adhered to a GFD all the time and 26% adhered most of the time.

Furthermore, results demonstrated that after adherence to a GFD for a median period of 6 years, 98% of patients reported a reduction of initial symptoms, and 85% declared that they had experienced an increase in HRQoL. A median weight gain of 8 kg as a consequence of a GFD was recorded.

The most prevalent diseases suffered by the patients were osteoporosis (15%), oral aphtae (12%), and dermatitis herpetiformis (9%).

Interestingly, compared to a control sample of individuals from the German population, celiac patients showed significantly higher scores for anxiety, fatigue, dyspeptic and musculoskeletal pain on the Hospital Anxiety and Depression Scale.

Celiac disease sufferers also showed a reduced HRQoL in nine out of 10 scales of the Medical Outcomes Study Short-Form 36.

Winifred Häuser, from the Klinikum Saarbrücken in Germany, and colleagues conclude that "HRQoL, although improved after starting a GFD, is still reduced compared to that of the general population."

"Further research is necessary to identify risk factors of a reduced HRQoL in celiac patients in order to develop tailored therapeutic interventions."

The research was published in the European Journal of Gastroenterology & Hepatology.