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Dietary Modification - Wheat-Gluten Free

Gastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet.

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Abstract Title:

Gastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet.

Abstract Source:

Clin Gastroenterol Hepatol. 2011 Mar ;9(3):214-9. Epub 2010 Jun 30. PMID: 20601132

Abstract Author(s):

Fabio Nachman, Horacio Vázquez, Andrea González, Paola Andrenacci, Liliana Compagni, Hugo Reyes, Emilia Sugai, María Laura Moreno, Edgardo Smecuol, Hui Jer Hwang, Inés Pinto Sánchez, Eduardo Mauriño, Julio César Bai

Article Affiliation:

Department of Medicine, Dr C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires, Argentina.

Abstract:

BACKGROUND & AIMS: Celiac disease (CD) patients often complain of symptoms consistent with gastroesophageal reflux disease (GERD). We aimed to assess the prevalence of GERD symptoms at diagnosis and to determine the impact of the gluten-free diet (GFD).

METHODS: We evaluated 133 adult CD patients at diagnosis and 70 healthy controls. Fifty-three patients completed questionnaires every 3 months during the first year and more than 4 years after diagnosis. GERD symptoms were evaluated using a subdimension of the Gastrointestinal Symptoms Rating Scale for heartburn and regurgitation domains.

RESULTS: At diagnosis, celiac patients had a significantly higher reflux symptom mean score than healthy controls (P<.001). At baseline, 30.1% of CD patients had moderate to severe GERD (score>3) compared with 5.7% of controls (P<.01). Moderate to severe symptoms were significantly associated with the classical clinical presentation of CD (35.0%) compared with atypical/silent cases (15.2%; P<.03). A rapid improvement was evidenced at 3 months after initial treatment with a GFD (P<.0001) with reflux scores comparable to healthy controls from this time point onward.

CONCLUSIONS: GERD symptoms are common in classically symptomatic untreated CD patients. The GFD is associated with a rapid and persistent improvement in reflux symptoms that resembles the healthy population.


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