Quality of life in celiac disease and the effect of gluten‐free diet

Abstract

Background and AimPatients with celiac disease (CD) have a poor health‐related quality of life (HR‐QOL). We assessed the QOL in patients with CD using both generic (SF‐12) and specific (CD‐QOL) questionnaires, and the effect of gluten‐free diet (GFD) on HR‐QOL.MethodsWe conducted a prospective follow‐up study based on consecutive patients of suspected CD between June 2014 and November 2015. After taking a detailed history, all patients were subjected to laboratory investigations (including complete blood count, biochemistry, and the IgA tTG antibody), followed by endoscopy and duodenal biopsies for histopathology. The HR‐QOL was assessed using SF‐12 and CD‐QOL questionnaires. Patients who were strictly adherent to GFD were re‐assessed at the end of 6 months for laboratory parameters and QOL.ResultsSixty adult patients of CD, with mean age of 28.85 ± 12.43 years, and a M:F ratio of 1.3:1, were enrolled in the study. The mean PCS (physical health composite scale score) and MCS (mental health composite scale score) at baseline were 37.20 ± 11.09 and 41.88 ± 8.39, which showed a statistically significant improvement after GFD to 50.30 ± 9.88 and 50.22 ± 9.04, respectively. Though there was no significant difference in the total CD‐QOL score after GFD, there was a significant improvement in the dysphoria and health‐concern subscales. We also found a negative correlation of the pre‐GFD symptom score (based on number of positive symptoms) with PCS and MCS and a positive correlation with the CD‐QOL score.ConclusionThis study has shown a reduced HR‐QOL in adult CD patients, which improves significantly on GFD, and is associated with a higher symptom number.

Food insecurity and other barriers to adherence to a gluten-free diet in individuals with celiac disease and non-celiac gluten sensitivity in the Netherlands: a mixed-methods study

“…The study sheds light on the mental and emotional challenges associated with adhering to a glutenfree diet, revealing feelings of restriction, burden, and the need for constant vigilance. Our research indicated a lower self-reported mental wellbeing in all participants with CeD and NCGS compared to the average Dutch population, based on the most recent data available from 2016 (43), aligning with previous studies emphasizing the impact of adhering to a gluten-free diet on mental health (44,45).…”

“…The study sheds light on the mental and emotional challenges associated with adhering to a gluten-free diet, revealing feelings of restriction, burden, and the need for constant vigilance. Our research indicated a lower self-reported mental wellbeing in all participants with CeD and NCGS compared to the average Dutch population, based on the most recent data available from 2016(43), aligning with previous studies emphasizing the impact of adhering to a gluten-free diet on mental health(44, 45). Particularly noteworthy, self-reported mental wellbeing was even lower among food insecure individuals, echoing results from a prior study reporting lower reported mental health among food insecure individuals on a gluten-free diet(46).…”