Intestinal Permeability in Long-Term Follow-up of Patients with Celiac Disease on a Gluten-Free Diet

The assessment of compliance of gluten-free diet (GFD) is a keystone in the supervision of celiac disease (CD) patients. Few data are available documenting evidence-based follow-up frequency for CD patients. In this work we aim at creating a criterion for timing of clinical follow-up for CD patients using data mining. We have applied data mining to a dataset with 188 CD patients on GFD (75% of them are children below 14 years old), evaluating the presence of gluten immunogenic peptides (GIP) in stools as an adherence to diet marker. The variables considered are gender, age, years following GFD and adherence to the GFD by fecal GIP. The results identify patients on GFD for more than two years (41.5% of the patients) as more prone to poor compliance and so needing more frequent follow-up than patients with less than 2 years on GFD. This is against the usual clinical practice of following less patients on long term GFD, as they are supposed to perform better. Our results support different timing follow-up frequency taking into consideration the number of years on GFD, age and gender. Patients on long term GFD should have a more frequent monitoring as they show a higher level of gluten exposure. A gender perspective should also be considered as non-compliance is partially linked to gender in our results: Males tend to get more gluten exposure, at least in the cultural context where our study was carried out. Children tend to perform better than teenagers or adults.

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Determinants And Trends Of Adherence To A Gluten-Free Diet In Adult Celiac Patients On A Long-Term Follow-Up (2000-2020)

Clinical Gastroenterology and Hepatology ◽

10.1016/j.cgh.2020.12.015 ◽

2020 ◽

Author(s):

Annalisa Schiepatti ◽

Stiliano Maimaris ◽

Maria Luisa Nicolardi ◽

Eleonora Alimenti ◽

Marta Vernero ◽

...

Keyword(s):

Gluten Free Diet ◽

Gluten Free ◽

Long Term Follow Up

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Long-Term Follow-Up of Celiac Adults on Gluten-Free Diet: Prevalence and Correlates of Intestinal Damage

Digestion ◽

10.1159/000066757 ◽

2002 ◽

Vol 66 (3) ◽

pp. 178-185 ◽

Cited By ~ 147

Author(s):

Carolina Ciacci ◽

Massimo Cirillo ◽

Raimondo Cavallaro ◽

Gabriele Mazzacca

Keyword(s):

Gluten Free Diet ◽

Intestinal Damage ◽

Gluten Free ◽

Long Term Follow Up

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Synchronous gastric and colonic MALT-lymphoma in coeliac disease: A long-term follow-up on gluten-free diet

Digestive and Liver Disease ◽

10.1016/j.dld.2006.07.016 ◽

2007 ◽

Vol 39 (11) ◽

pp. 1035-1038 ◽

Cited By ~ 3

Author(s):

A. Tursi ◽

C.D. Inchingolo

Keyword(s):

Coeliac Disease ◽

Malt Lymphoma ◽

Gluten Free Diet ◽

Gluten Free ◽

Long Term Follow Up

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Descriptive Study of the Different Tools Used to Evaluate the Adherence to a Gluten-Free Diet in Celiac Disease Patients

Nutrients ◽

10.3390/nu10111777 ◽

2018 ◽

Vol 10 (11) ◽

pp. 1777 ◽

Cited By ~ 5

Author(s):

Luis Rodrigo ◽

Isabel Pérez-Martinez ◽

Eugenia Lauret-Braña ◽

Adolfo Suárez-González

Keyword(s):

Celiac Disease ◽

Multidisciplinary Approach ◽

Descriptive Study ◽

Duodenal Mucosa ◽

Gluten Free Diet ◽

Gluten Free ◽

Autoimmune Process ◽

Duodenal Biopsies

Celiac disease (CD) is a genetically conditioned autoimmune process that appears in susceptible people. It can affect people of any age, and slightly predominates in females. It has a fairly homogenous global distribution, with an average prevalence of 1–2%, the frequency having increased in recent decades. The only effective treatment is a strict and permanent gluten-free diet (GFD), although the level of compliance is poor, at about 50% of cases. To monitor the effectiveness of the GFD, several procedures involving various approaches are employed: (a) Periodic visits by expert Nutritionists; (b) Clinical follow-up; (c) Serological time controls of specific antibodies; (d) Serial endoscopies with collection of duodenal biopsies; (e) Use of structured questionnaires; and (f) Determination of gluten peptides derived from gluten in faeces and/or urine. All of these procedures are useful when applied, alone or in combination, depending on the cases. Some patients will only need to consult to their doctors, while others will require a multidisciplinary approach to assess their compliance with the GFD. In children, normalization of duodenal mucosa was achieved in 95% of cases within two years, while it is more delayed in adults, whose mucosa take longer time (3–5 years) to heal completely.

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