Follow-up of patients with celiac disease: Achieving compliance with treatment

Pietzak, Michelle

doi:10.1053/j.gastro.2005.02.025

Cited by 179 publications

(178 citation statements)

References 57 publications

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“…Previous studies have shown that adolescents and those diagnosed with CD by serologic screening are less likely to adhere strictly to a GFD when compared to younger children and adults diagnosed because of classical symptoms [20][21][22][23]. Rates of adherence in adolescent populations vary from 56% to 83% [21,24], while individuals diagnosed with CD at a very young age are reported to have the highest rates of adherence [20]. Furthermore, in a Swedish study, only 36% of adults who were diagnosed with CD at four years of age or older were found to be compliant with the GFD, as compared to 80% of those adults diagnosed prior to their fourth birthday [16].…”

Section: Discussionmentioning

confidence: 99%

Factors that Influence Adherence to a Gluten-Free Diet in Adults with Celiac Disease

et al. 2007

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Objective-The only treatment for celiac disease is lifelong adherence to a gluten-free diet, yet adherence is limited and factors influencing adherence are poorly understood. The purpose of this study was to determine factors influencing gluten-free diet adherence in adults with celiac disease.Methods-A questionnaire was developed and administered to 154 adults with celiac disease who then underwent a standardized gluten-free diet evaluation by an experienced nutritionist. Multivariate analysis was conducted to determine factors associated with adherence level.Results-Thirteen factors hypothesized to contribute to gluten-free diet adherence were found to be significantly associated with improved adherence including: understanding of the gluten-free diet, membership of a celiac disease advocacy group, and perceived ability to maintain adherence despite travel or changes in mood or stress (P < 0.001). Conclusions-This study identified specific factors correlated with gluten-free diet adherence. These results provide a foundation for the design of educational interventions to improve adherence. NIH Public Access

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Section: Discussionmentioning

confidence: 99%

Factors that Influence Adherence to a Gluten-Free Diet in Adults with Celiac Disease

et al. 2007

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“…Furthermore, while the availability of gluten-free foods has steadily increased, gluten-free foods tend to be costly and of inferior palatability to regular foods; the limited access to gluten-free foods also evokes social pressures and isolation when an individual with CD engages in eating at a restaurant with peers [51]. Particularly for children from low socioeconomic backgrounds, obtaining expensive gluten-free food may pose as a risk for poor gluten-free diet adherence, increase in symptoms, and decreased psychological well-being [52,53]. Ongoing consultation and support from a multidisciplinary medical team is considered to be an ideal mechanism to improve gluten-free diet compliance [52].…”

Section: Ed Risk Factors Associated With CDmentioning

confidence: 99%

“…Particularly for children from low socioeconomic backgrounds, obtaining expensive gluten-free food may pose as a risk for poor gluten-free diet adherence, increase in symptoms, and decreased psychological well-being [52,53]. Ongoing consultation and support from a multidisciplinary medical team is considered to be an ideal mechanism to improve gluten-free diet compliance [52]. All CD-related risk factors for eating pathology are summarized in Table 3.…”

Section: Ed Risk Factors Associated With CDmentioning

confidence: 99%

Adolescents with Diet-Related Chronic Health Conditions (DRCHCs) and Unique Risk for Development of Eating Pathology

David¹,

Culnan²,

Эрнст³

2017

J Child Adolesc Behav

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Diet-Related Chronic Health Conditions (DRCHCs) are a subset of chronic health illnesses, which presently includes Inflammatory Bowel Disease (IBD), Type 1 Diabetes (T1D), Cystic Fibrosis (CF), and Celiac Disease (CD). Food and diet play integral roles in the management and progression of each condition. The diversity of treatments for DRCHCs encompass therapies that impact diet, weight, and body shape, such as steroids, insulin, and special and/or restrictive diets. Often with efforts to control unwanted side effects of the myriad of treatments, there is poor adherence to prescribed therapies. Given the psychosocial burden of DRCHCs, and the high degree of focus on weight and diet involved in managing each disorder, it is not surprising that those living with DRCHCs may be at risk for developing body image concerns, including poor body image and weight concerns, which may increase the risk for the development of eating pathology. In addition to summarizing current eating pathology risk factors present in DRCHCs, the proposed article builds on previous research by recommending an expansion of the category of DRCHCs to include Type II Diabetes and serious/anaphylactic food allergies, and hypothesizes DRCHC-specific eating pathology risk factors, such as hyper focus on weight, medically-related food restriction, and societal acceptance of thinness despite health issues. The article concludes with clinical recommendations for pediatric medical providers to potentially minimize the negative impact of DRCHC on pediatric patients' medical and psychosocial outcomes.

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“…These interventions can be undertaken by more than one healthcare professional, although there are strong recommendations that an expert dietitian should be involved (16)(17)(18)(19) . There are some established dietitian-led clinics (20) with access to a gastroenterologist as necessary.…”

Section: Follow-up Interventionsmentioning

confidence: 99%

Symposium 1: Joint BAPEN and British Society of Gastroenterology Symposium on ‘Coeliac disease: basics and controversies’ Dietitians are better than clinicians in following up coeliac disease

2009

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It seems obvious to healthcare professionals that patients with coeliac disease should receive regular follow-up. Surprisingly, there is little evidence that patients benefit in terms of reduced morbidity or mortality. However, several authoritative bodies have published guidelines on the management of coeliac disease that recommend regular follow-up. There is good evidence that compliance with a gluten-free diet reduces the risk of complications such as osteoporosis or small bowel lymphoma. Compliance is enhanced particularly by education about the disease and the gluten-free diet and by support from peers or professionals. Such input can be provided by regular follow-up, which thereby should improve compliance and hence long-term health. The consensus of the recommendations for follow-up suggests an annual review by a physician and dietitian. At annual follow-up the disease status can be checked and nutritional advice can be given, including checking the adequacy of, and the compliance with, the gluten-free diet. Complications and associated medical conditions can be sought, genetic risks explained and support and reassurance given. Specialist dietitians have particular expertise in relation to diet and nutritional management; specialist clinicians have a broader range of expertise in many aspects of management of the disease. A team approach for providing follow-up is the ideal, with a clinician and dietitian, both with expertise in coeliac disease, being involved. No one particular group of healthcare professionals is necessarily better than the other at providing follow-up.

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Follow-up of patients with celiac disease: Achieving compliance with treatment

Cited by 179 publications

References 57 publications

Factors that Influence Adherence to a Gluten-Free Diet in Adults with Celiac Disease

Factors that Influence Adherence to a Gluten-Free Diet in Adults with Celiac Disease

Adolescents with Diet-Related Chronic Health Conditions (DRCHCs) and Unique Risk for Development of Eating Pathology

Symposium 1: Joint BAPEN and British Society of Gastroenterology Symposium on ‘Coeliac disease: basics and controversies’ Dietitians are better than clinicians in following up coeliac disease

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