Appetite and Gastrointestinal Hormone Response to a Gluten-Free Meal in Patients with Coeliac Disease

Coeliac disease (CeD) is an immune-mediated inflammatory enteropathy triggered by the ingestion of gluten in genetically susceptible individuals. Gastrointestinal (GI) hormone response related to appetite and glucose metabolism is still under-investigated in patients with CeD. This study aimed at shedding light on the appetite sensations, glycaemia and hormone response induced by a complex meal in patients with coeliac disease. Twenty-two women with CeD, nine at the diagnosis (CeDD) and thirteen under a gluten-free diet (CeDGF), and ten healthy subjects (HS) were enrolled in a single day intervention study. All subjects consumed a test meal, recorded their appetite sensations, and blood was collected over three hours after meal consumption. The study found a lower decrease in hunger in CeDD compared to CeDGF and HS after meal intake. Data showed no difference of fullness and satiety between the groups. CeDD had lower insulin and glucose-dependent insulinotropic polypeptide (GIP) than CeDGF and HS. Both CeDD and CeDGF experienced a lower post-prandial response of glucose than HS. Data suggested that patients with CeD have an impaired glucose absorption after more than 12 months of gluten-free diet. Postprandial GIP may play a significant role in appetite cues and insulin response to a complex meal.

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P.12.1 GLUTEN-FREE DIET DOES NOT INFLUENCE THE OCCURRENCE AND THE TH1/TH17-TH2 NATURE OF IMMUNE-MEDIATED DISEASE IN PATIENTS WITH COELIAC DISEASE

Digestive and Liver Disease ◽

10.1016/s1590-8658(16)30283-3 ◽

2016 ◽

Vol 48 ◽

pp. e184-e185

Author(s):

N. Imperatore ◽

R. Tortora ◽

P. Capone ◽

S. Donetto ◽

G.D. De Palma ◽

...

Keyword(s):

Coeliac Disease ◽

Gluten Free Diet ◽

Gluten Free ◽

Immune Mediated

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Gluten-free diet does not influence the occurrence and the Th1/Th17-Th2 nature of immune-mediated diseases in patients with coeliac disease

Digestive and Liver Disease ◽

10.1016/j.dld.2016.03.026 ◽

2016 ◽

Vol 48 (7) ◽

pp. 740-744 ◽

Cited By ~ 7

Author(s):

Nicola Imperatore ◽

Antonio Rispo ◽

Pietro Capone ◽

Sara Donetto ◽

Giovanni Domenico De Palma ◽

...

Keyword(s):

Coeliac Disease ◽

Gluten Free Diet ◽

Gluten Free ◽

Immune Mediated

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The Role of the Gluten-Free Diet in the Management of Seronegative Enteropathy

Nutrients ◽

10.3390/nu13114027 ◽

2021 ◽

Vol 13 (11) ◽

pp. 4027

Author(s):

Anna Szaflarska-Popławska

Keyword(s):

Differential Diagnosis ◽

Coeliac Disease ◽

Immunosuppressive Therapy ◽

Villous Atrophy ◽

Gluten Free Diet ◽

Evidence Based ◽

Gluten Free ◽

Clinical Challenge ◽

Immune Mediated

The differential diagnosis and treatment of seronegative enteropathy, also termed seronegative villous atrophy (SNVA), is a clinical challenge. Although seronegative coeliac disease (CD) is a frequent cause of SNVA, the aetiology can include immune-mediated, inflammatory, infectious, and drug-related forms. As a misdiagnosis of SNVA can result in patients being unnecessarily placed on a lifelong strict gluten-free diet or even given incorrect immunosuppressive therapy, the aim of this paper is to provide an evidence-based and practical approach for the workup and management of SNVA.

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Micronutrient deficiencies in children with coeliac disease; a double-edged sword of both untreated disease and treatment with gluten-free diet

Clinical Nutrition ◽

10.1016/j.clnu.2021.03.006 ◽

2021 ◽

Author(s):

Lorcan McGrogan ◽

Mary Mackinder ◽

Fiona Stefanowicz ◽

Maria Aroutiounova ◽

Anthony Catchpole ◽

...

Keyword(s):

Coeliac Disease ◽

Gluten Free Diet ◽

Gluten Free ◽

Micronutrient Deficiencies

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Wait-and-See Approach or Gluten-Free Diet Administration—The Rational Management of Potential Coeliac Disease

Nutrients ◽

10.3390/nu13030947 ◽

2021 ◽

Vol 13 (3) ◽

pp. 947

Author(s):

Anna Szaflarska-Popławska

Keyword(s):

Small Intestine ◽

Celiac Disease ◽

Prognostic Factors ◽

Coeliac Disease ◽

Gluten Free Diet ◽

Gluten Free ◽

Individual Basis ◽

Therapeutic Decisions ◽

Rational Management ◽

Wait And See

Potential celiac disease (PCD) is a heterogeneous disease; only some patients develop full celiac disease (CD), characterised by advanced atrophic changes in the small intestine. Few accurate prognostic factors exist for the progression of PCD; therefore, therapeutic decisions should be made on an individual basis in each case. Patients with clinical gastroenterological or parenteral symptoms often benefit from a gluten-free diet, and those left on a diet containing gluten should receive clinical, serological and histopathological supervision.

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The impact of symptoms on quality of life before and after diagnosis of coeliac disease: the results from a Polish population survey and comparison with the results from the United Kingdom

BMC Gastroenterology ◽

10.1186/s12876-021-01673-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Emilia Majsiak ◽

Magdalena Choina ◽

Dominik Golicki ◽

Alastair M. Gray ◽

Bożena Cukrowska

Keyword(s):

Quality Of Life ◽

United Kingdom ◽

Coeliac Disease ◽

Gluten Free Diet ◽

Gluten Free ◽

The United Kingdom ◽

Before And After ◽

The Mean ◽

The Uk

Abstract Background Coeliac disease (CD) is characterised by diverse clinical symptoms, which may cause diagnostic problems and reduce the patients’ quality of life. A study conducted in the United Kingdom (UK) revealed that the mean time between the onset of coeliac symptoms and being diagnosed was above 13 years. This study aimed to analyse the diagnostic process of CD in Poland and evaluate the quality of life of patients before and after CD diagnosis. In addition, results were compared to the results of the original study conducted in the UK. Methods The study included 2500 members of the Polish Coeliac Society. The patients were asked to complete a questionnaire containing questions on socio-demographic factors, clinical aspects and quality of life, using the EQ-5D questionnaire. Questionnaires received from 796 respondents were included in the final analysis. Results The most common symptoms reported by respondents were bloating (75%), abdominal pain (72%), chronic fatigue (63%) and anaemia (58%). Anaemia was the most persistent symptom, with mean duration prior to CD diagnosis of 9.2 years, whereas diarrhoea was observed for the shortest period (4.7 years). The mean duration of any symptom before CD diagnosis was 7.3 years, compared to 13.2 years in the UK. CD diagnosis and the introduction of a gluten-free diet substantially improved the quality of life in each of the five EQ-5D-5L health dimensions: pain and discomfort, anxiety and depression, usual activities, self-care and mobility (p < 0.001), the EQ-Index by 0.149 (SD 0.23) and the EQ-VAS by 30.4 (SD 28.3) points. Conclusions Duration of symptoms prior to the diagnosis of CD in Poland, although shorter than in the UK, was long with an average of 7.3 years from first CD symptoms. Faster CD diagnosis after the onset of symptoms in Polish respondents may be related to a higher percentage of children in the Polish sample. Introduction of a gluten-free diet improves coeliac patients’ quality of life. These results suggest that doctors should be made more aware of CD and its symptoms across all age groups.

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