Effect of a gluten-free diet on quality of life in patients with nonclassical versus classical presentations of celiac disease

Rok Seon Choung, Abhinav Lamba, Eric V. Marietta, Jacalyn A. See, Joseph J. Larson, Katherine S. King, Carol T. Van Dyke, Alberto R. Tapia, Joseph A. Murray

Research output: Contribution to journalArticle

Abstract

Background: Celiac disease (CD) often presents with symptoms of diarrhea and malabsorption, termed classical CD. However, it can also present as nonclassical CD, which is commonly associated with nongastrointestinal symptoms. Studies suggest that nonclassical CD tends to have less severe symptoms than classical CD, which may affect both adherence to a gluten-free diet (GFD) and psychological stress. Therefore, we compared adherence to a GFD and psychological measures, including quality of life (QOL) and somatization, between patients with nonclassical and classical presentations of CD. Methods: Patients at a tertiary care center with biopsy-proven CD, who completed a Talley Bowel Disease Questionnaire and the Short Form-36 at diagnosis and who had been on a GFD for at least 1 year, were included in this study. Patients were further surveyed to assess gastrointestinal symptoms, QOL, Somatization Symptom Checklist (SSC), and adherence to a GFD. Results were compared between patients with classical versus nonclassical CD presentation. Results: Among 122 patients included in this study, 62 had classical CD and 60 had nonclassical CD. At diagnosis, health-related QOL was lower in the classical CD group than in the nonclassical CD group. After following a GFD, both groups had improved QOL after following a GFD, and body mass index significantly increased in both groups. Most subscales of QOL, SSC scores, and adherence to the GFD were similar between the groups, except the Short Form-36 Mental Component summary scores that were still lower in the classical CD (48.4 vs. 52.6 nonclassical CD group; P=0.03). Conclusions: Despite QOL at diagnosis being higher in those with nonclassical CD versus lower in those with classical CD, both groups had improved QOL and achieved a similar QOL after following a GFD.

Original languageEnglish (US)
JournalJournal of clinical gastroenterology
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Gluten-Free Diet
Celiac Disease
Quality of Life
Checklist

Keywords

  • celiac disease
  • epidemiology
  • gluten-free diet
  • phenotypes
  • survey

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Effect of a gluten-free diet on quality of life in patients with nonclassical versus classical presentations of celiac disease. / Choung, Rok Seon; Lamba, Abhinav; Marietta, Eric V.; See, Jacalyn A.; Larson, Joseph J.; King, Katherine S.; Van Dyke, Carol T.; Tapia, Alberto R.; Murray, Joseph A.

In: Journal of clinical gastroenterology, 01.01.2019.

Research output: Contribution to journalArticle

Choung, Rok Seon ; Lamba, Abhinav ; Marietta, Eric V. ; See, Jacalyn A. ; Larson, Joseph J. ; King, Katherine S. ; Van Dyke, Carol T. ; Tapia, Alberto R. ; Murray, Joseph A. / Effect of a gluten-free diet on quality of life in patients with nonclassical versus classical presentations of celiac disease. In: Journal of clinical gastroenterology. 2019.
@article{001a848b32fb40f48d0947f7f1eb265e,
title = "Effect of a gluten-free diet on quality of life in patients with nonclassical versus classical presentations of celiac disease",
abstract = "Background: Celiac disease (CD) often presents with symptoms of diarrhea and malabsorption, termed classical CD. However, it can also present as nonclassical CD, which is commonly associated with nongastrointestinal symptoms. Studies suggest that nonclassical CD tends to have less severe symptoms than classical CD, which may affect both adherence to a gluten-free diet (GFD) and psychological stress. Therefore, we compared adherence to a GFD and psychological measures, including quality of life (QOL) and somatization, between patients with nonclassical and classical presentations of CD. Methods: Patients at a tertiary care center with biopsy-proven CD, who completed a Talley Bowel Disease Questionnaire and the Short Form-36 at diagnosis and who had been on a GFD for at least 1 year, were included in this study. Patients were further surveyed to assess gastrointestinal symptoms, QOL, Somatization Symptom Checklist (SSC), and adherence to a GFD. Results were compared between patients with classical versus nonclassical CD presentation. Results: Among 122 patients included in this study, 62 had classical CD and 60 had nonclassical CD. At diagnosis, health-related QOL was lower in the classical CD group than in the nonclassical CD group. After following a GFD, both groups had improved QOL after following a GFD, and body mass index significantly increased in both groups. Most subscales of QOL, SSC scores, and adherence to the GFD were similar between the groups, except the Short Form-36 Mental Component summary scores that were still lower in the classical CD (48.4 vs. 52.6 nonclassical CD group; P=0.03). Conclusions: Despite QOL at diagnosis being higher in those with nonclassical CD versus lower in those with classical CD, both groups had improved QOL and achieved a similar QOL after following a GFD.",
keywords = "celiac disease, epidemiology, gluten-free diet, phenotypes, survey",
author = "Choung, {Rok Seon} and Abhinav Lamba and Marietta, {Eric V.} and See, {Jacalyn A.} and Larson, {Joseph J.} and King, {Katherine S.} and {Van Dyke}, {Carol T.} and Tapia, {Alberto R.} and Murray, {Joseph A.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1097/MCG.0000000000001277",
language = "English (US)",
journal = "Journal of Clinical Gastroenterology",
issn = "0192-0790",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Effect of a gluten-free diet on quality of life in patients with nonclassical versus classical presentations of celiac disease

AU - Choung, Rok Seon

AU - Lamba, Abhinav

AU - Marietta, Eric V.

AU - See, Jacalyn A.

AU - Larson, Joseph J.

AU - King, Katherine S.

AU - Van Dyke, Carol T.

AU - Tapia, Alberto R.

AU - Murray, Joseph A.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Celiac disease (CD) often presents with symptoms of diarrhea and malabsorption, termed classical CD. However, it can also present as nonclassical CD, which is commonly associated with nongastrointestinal symptoms. Studies suggest that nonclassical CD tends to have less severe symptoms than classical CD, which may affect both adherence to a gluten-free diet (GFD) and psychological stress. Therefore, we compared adherence to a GFD and psychological measures, including quality of life (QOL) and somatization, between patients with nonclassical and classical presentations of CD. Methods: Patients at a tertiary care center with biopsy-proven CD, who completed a Talley Bowel Disease Questionnaire and the Short Form-36 at diagnosis and who had been on a GFD for at least 1 year, were included in this study. Patients were further surveyed to assess gastrointestinal symptoms, QOL, Somatization Symptom Checklist (SSC), and adherence to a GFD. Results were compared between patients with classical versus nonclassical CD presentation. Results: Among 122 patients included in this study, 62 had classical CD and 60 had nonclassical CD. At diagnosis, health-related QOL was lower in the classical CD group than in the nonclassical CD group. After following a GFD, both groups had improved QOL after following a GFD, and body mass index significantly increased in both groups. Most subscales of QOL, SSC scores, and adherence to the GFD were similar between the groups, except the Short Form-36 Mental Component summary scores that were still lower in the classical CD (48.4 vs. 52.6 nonclassical CD group; P=0.03). Conclusions: Despite QOL at diagnosis being higher in those with nonclassical CD versus lower in those with classical CD, both groups had improved QOL and achieved a similar QOL after following a GFD.

AB - Background: Celiac disease (CD) often presents with symptoms of diarrhea and malabsorption, termed classical CD. However, it can also present as nonclassical CD, which is commonly associated with nongastrointestinal symptoms. Studies suggest that nonclassical CD tends to have less severe symptoms than classical CD, which may affect both adherence to a gluten-free diet (GFD) and psychological stress. Therefore, we compared adherence to a GFD and psychological measures, including quality of life (QOL) and somatization, between patients with nonclassical and classical presentations of CD. Methods: Patients at a tertiary care center with biopsy-proven CD, who completed a Talley Bowel Disease Questionnaire and the Short Form-36 at diagnosis and who had been on a GFD for at least 1 year, were included in this study. Patients were further surveyed to assess gastrointestinal symptoms, QOL, Somatization Symptom Checklist (SSC), and adherence to a GFD. Results were compared between patients with classical versus nonclassical CD presentation. Results: Among 122 patients included in this study, 62 had classical CD and 60 had nonclassical CD. At diagnosis, health-related QOL was lower in the classical CD group than in the nonclassical CD group. After following a GFD, both groups had improved QOL after following a GFD, and body mass index significantly increased in both groups. Most subscales of QOL, SSC scores, and adherence to the GFD were similar between the groups, except the Short Form-36 Mental Component summary scores that were still lower in the classical CD (48.4 vs. 52.6 nonclassical CD group; P=0.03). Conclusions: Despite QOL at diagnosis being higher in those with nonclassical CD versus lower in those with classical CD, both groups had improved QOL and achieved a similar QOL after following a GFD.

KW - celiac disease

KW - epidemiology

KW - gluten-free diet

KW - phenotypes

KW - survey

UR - http://www.scopus.com/inward/record.url?scp=85074471897&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85074471897&partnerID=8YFLogxK

U2 - 10.1097/MCG.0000000000001277

DO - 10.1097/MCG.0000000000001277

M3 - Article

C2 - 31688364

AN - SCOPUS:85074471897

JO - Journal of Clinical Gastroenterology

JF - Journal of Clinical Gastroenterology

SN - 0192-0790

ER -