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- Title
Outcome of Celiac Disease after Two Years of Gluten-Free Diet.
- Authors
Hussein Al-Shebani, Abbas Mohammed
- Abstract
Background: Celiac Disease (CD) is one of the most common diseases of gastrointestinal tract (GIT) and presents clinically with a wide range of GIT and non-GIT manifestations. In addition, the diagnosis of CD depends on clinical features with presence of anti-CD antibodies and the presence of specific histological changes on small bowel biopsy. Aim of study: To evaluate the role of anti-CD antibodies in follow up of patients with CD and to study the rate of relapse in CD symptoms after re-introducing gluten after 2 years of gluten-free diet. Method: This study done in Al-diwaniyah maternity and children hospital in the period from 1st of February 2014 until the 1st of July 2017 and involved sixty three patients diagnosed as having CD depending on clinical features and the presence of positive anti-CD antibodies (anti-gliadin and anti tissue glutaminase). Then all these patients were referred to GIT center for small bowel biopsy. If the classical histological findings were present in the biopsy, then the patient involved in the study. Five patients refused to do biopsy, so 58 patients were involved in this study and full instructions about the diet of the patient were discussed with their families. Also, mobile phone No. was obtained from each caregiver for follow up every three months with full history, examination and measurements of auto-antibodies. After 2 years another small bowel biopsy done for all patients included in the study. Results: Forty nine patients (96%) have normal biopsy and 2 (3.9%) still have abnormal changes in bowel mucosa. These 2 patient were excluded from the study and the other 49 patients reintroduced gluten in their diet gradually with close observation for relapse of symptoms and for detection of any complications. After three months of gluten-containing diet, a third biopsy was done. Forty one (83%) patient had recurrence of signs and symptoms of celiac disease and have abnormal biopsy findings so they were kept on gluten-free diet for life. Eight patients (16%) did not develop any signs and symptoms and they still have normal biopsy in spite of receiving gluten-containing diet for the last three months. Conclusion: Anti-CD antibodies have a valuable role in follow-up of patients on gluten-free diet and sixteen percent of patient may have complete cure and complete normalization of bowel mucosa even after reintroducing gluten-containing diet.
- Publication
Indian Journal of Public Health Research & Development, 2018, Vol 9, Issue 11, p1926
- ISSN
0976-0245
- Publication type
Article
- DOI
10.5958/0976-5506.2018.01731.X