Clinical Characteristics of Celiac Disease and Dietary Adherence to Gluten-Free Diet among Saudi Children

Sarkhy, Ahmed Al; Mouzan, Mohammad I. El; Saeed, Elshazaly; Alanazi, Aziz; Alghamdi, Sharifa; Anil, Shirin; Assiri, Asaad

doi:10.5223/pghn.2015.18.1.23

Cited by 18 publications

(39 citation statements)

References 18 publications

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“…The majority of our patients were women (68.6%), which was consistent with other studies, in which a slight predominance of females was observed [ 12 , 17 – 20 , 22 , 24 , 26 ].…”

Section: Discussionsupporting

confidence: 93%

Rate and determinants of non-adherence to a gluten-free diet and nutritional status assessment in children and adolescents with celiac disease in a tertiary Brazilian referral center: a cross-sectional and retrospective study

2018

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BackgroundCompliance with a gluten-free diet (GFD) is difficult at all ages but particularly for teenagers due to social, cultural, economic, and practical pressures. The multidisciplinary team responsible for the treatment of patients with celiac disease and give support to their parents plays a special role on strengthening GFD and assessing the nutritional and physical health.MethodsA cross-sectional and retrospective study including patients under 20 years of age, with biopsy-confirmed CD, followed regularly at the Department of Pediatrics, Division of Gastroenterology, Hospital das Clínicas, University of Sao Paulo, School of Medicine, Sao Paulo, Brazil, were surveyed using a questionnaire and serologic test applied between November 2011 and February 2012. A retrospective chart review of these patients was performed to collect the anthropometric data along with the results of the serologic test performed at the time of diagnosis and after at least 1 year of treatment with a GFD.ResultsWe evaluated 35 patients aged between 2.4 and 19.9 years. Of these 68.6% were female, 88.6% had the typical form of the disease and 51.4% had other comorbidities. The mean age at diagnosis was 5.4 years. Despite dietary guidance, 20% reported non-adherence to the diet. Most children recovered the weight and height deficit after 5 years of treatment, and in some children, excessive weight gain became a concern.ConclusionThe majority of transgressions occurred intentionally at home or at parties. There was a risk of excessive weight gain, especially in the first two years of treatment. More alternatives and easier access to low cost gluten-free foods, increasing the discussion about the benefits of adhering to a GFD among patients, families, and the general population, besides the acquisition of self-management skills, are crucial to fostering independent children and adolescents who have the knowledge and tools to manage life with CD.Electronic supplementary materialThe online version of this article (10.1186/s12876-018-0740-z) contains supplementary material, which is available to authorized users.

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“…The majority of our patients were women (68.6%), which was consistent with other studies, in which a slight predominance of females was observed [ 12 , 17 – 20 , 22 , 24 , 26 ].…”

Section: Discussionsupporting

confidence: 93%

Rate and determinants of non-adherence to a gluten-free diet and nutritional status assessment in children and adolescents with celiac disease in a tertiary Brazilian referral center: a cross-sectional and retrospective study

2018

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“…One or two decades ago, recurrent abdominal pain was rarely associated with celiac disease and for this presentation, serology screening was not considered to be justified (17). Later, this became one of the frequently seen clinical presentation in Western European countries, North America (6,(18)(19)(20) and other geographical areas (21,22) as a single clinical manifestation or in association with other symptoms. In the study of Khatib that looked at a group of celiac children recently diagnosed (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013) in United States, abdominal pain was reported in higher percentages than diarrhea, being the most frequent digestive symptom (23).…”

Section: Discussionmentioning

confidence: 99%

Celiac Disease Case Finding Strategy in Romanian Symptomatic Children

Lešanu¹,

Vlad²,

Becheanu³

et al. 2017

Ro J Pediatr.

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Objectives. Pediatricians face various challenges in different stages of celiac disease (CD) diagnosis. Whom to test is intensely debated because of CD's heterogenous clinical spectrum. The main purpose of the study was to identify symptoms or symptom associations that should initiate an active strategy of CD early diagnosis in Romanian children. Material and method. We conducted a prospective study in "Grigore Alexandrescu" Emergency Children's Hospital. From March 2013 until February 2014, 249 children with symptoms/signs at risk of CD were included. Results. CD was diagnosed in 11 (1/21 patients evaluated). One in 12.6; 16; 18; 18.5 and 18.5 children respectively with chronic diarrhea, low stature, growth failure, recurrent abdominal pain and constipation had CD. Certain symptom associations increased the risk: classical symptom associations (chronic diarrhea and weight loss), as well as other associations: recurrent abdominal pain and weight loss, constipation and weight loss, constipation and refractory iron deficiency anemia. Conclusion. Active screening among patients with symptoms and especially symptom associations at risk of CD would improve diagnosis rates in pediatric CD.

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“…We recently have shown that the compliance to GFD among Saudi children is relatively poor (62%) compared to other parts of the world [ 10 ]. As there are no local data looking for the socio-economic impact of GFD on celiac patients, we aimed, in the present study, to examine the socio-economic impact of GFD on Saudi children with CD and their families.…”

Section: Discussionmentioning

confidence: 99%

“…The questionnaire consisted of four sections: the first section inquired about the demographic data of the child and family, the second section was on diagnostic details, while the third section had questions about family knowledge about GFD, its effect on the child's symptoms and the compliance of the child. The data from the previous 3 sections was recently published elsewhere [ 10 ].…”

Section: Methodsmentioning

confidence: 99%

“…We have recently shown that Saudi children have relatively poor compliance to GFD compared to those from other countries [ 10 ]. Different factors contribute to this relatively poor compliance rate, including: limited availability of GFD products, their cost, and the limited financial support from the health sectors in supplying free GFD products [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Socioeconomic Impacts of Gluten-Free Diet among Saudi Children with Celiac Disease

Sarkhy

Mouzan

Saeed

et al. 2016

Pediatr Gastroenterol Hepatol Nutr

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PurposeTo determine the socio-economic impact of gluten free diet (GFD) on Saudi children and their families.MethodsA cross-sectional study was conducted in which an online questionnaire was sent to all families registered in the Saudi celiac patients support group. We included only children (age 18 years of age and younger) with biopsy-confirmed celiac disease (CD).ResultsA total of 113 children were included in the final analysis, the median age was 9.9 years; 62.8% were females. One hundred (88.5%) of the participating families reported that GFD food was not easily available in their areas, 17% of them reported that it was not available at all in their area. One hundred and six (93.8%) reported that the price of GFD food was very expensive and 70 (61.9%) families that the diet was heavily affecting their family budget. Significant social difficulties were reported among the participating families and their children including interference with the child's interaction with other children (49.6%), the families' ability to attend social gatherings (60.2%), the families' ability to eat in restaurants (73.5%), and the families' ability to travel (58.4%).ConclusionThere is significant negative socio-economic impact of GFD on children with CD & their families. Health care providers should be aware of these psycho-social difficulties and be well trained to provide a proper education and psychological support for these patients and their families.

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Clinical Characteristics of Celiac Disease and Dietary Adherence to Gluten-Free Diet among Saudi Children

Cited by 18 publications

References 18 publications

Rate and determinants of non-adherence to a gluten-free diet and nutritional status assessment in children and adolescents with celiac disease in a tertiary Brazilian referral center: a cross-sectional and retrospective study

Rate and determinants of non-adherence to a gluten-free diet and nutritional status assessment in children and adolescents with celiac disease in a tertiary Brazilian referral center: a cross-sectional and retrospective study

Celiac Disease Case Finding Strategy in Romanian Symptomatic Children

Socioeconomic Impacts of Gluten-Free Diet among Saudi Children with Celiac Disease

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