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

BACKGROUND AND AIM

Patients 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.

METHODS

We 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.

RESULTS

Sixty 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.

CONCLUSION

This study has shown a reduced HR-QOL in adult CD patients, which improves significantly on GFD, and is associated with a higher symptom number.