Clinical, serological and histological remission in celiac disease is strictly related to long life complete exclusion of gluten from the diet. Because celiac disease is an autoimmune systemic disorder the potential complications include a wide spectrum with two severe long-term morbidities: osteoporosis and malignancy. Gluten free diet, easy to be recommended, is difficult to be followed. This study aimed at evaluating the diagnostic criteria and dietary instruction, quality of life issues, impact of the gluten free diet on the celiac patient.
Material and method: 250 patients (mean age at diagnosis 18.18 years) on gluten-free diet were asked to fill out a disease specific questionnaire.
Results: The response rate was 58.4% (mean age at diagnosis 11 years); 7% had no biopsy proven diagnosis (being excluded) and 28.26% had only antigliadin antibodies tested as serology method; 84.78% had typical digestive symptoms at diagnosis; 28.2% had been followed up after the diagnosis; information about the disease and diet have been provided exclusively by the gastroenterologist in 95.6% of the responders, 45.6% considering the information insufficient. The gluten free products were considered in 73.9% of cases too expensive for the family income, with low availability, lack of variety and unclear labeling; 48.8% reported impaired access to certain activities (social events, traveling) and even having difficulties to be accepted for some jobs.
Conclusions: There is evidence that an educational program is needed to improve knowledge on the atypical forms of disease, diagnostic criteria and tools. The quality of life would be improved by support groups for patients, improved availability, better prices and food labeling.