Quality of life of coeliac patients before and after initiation of the gluten-free diet

Abstract

Coeliac disease is characterised by malabsorption resulting from inflammatory injury to the mucosa of the small intestine after ingestion of wheat gluten or related rye and barley proteins. There is clinical and histologic improvement on a strict gluten-free diet (GFD) and relapse when dietary gluten is reintroduced. Quality of life of coeliac patients is often impaired since the GFD has an impact on a person's social and physiological well-being. The study consisted of two parts. In Study I, the quality of life of newly diagnosed coeliac patients was assessed by means of a questionnaire, and compared to the quality of life of coeliac patients established on a gluten-free diet and to control groups. In Study II, focus groups were held on two occasions to discuss issues affecting Coeliac patients eg: availability of gluten-free food, factors leading to lack of compliance, food labeling etc. Results of Study I show that the quality of life, as assessed by the Gastrointestinal Quality of Life Index (GIQLI) and SF-36, was highest in the Control Group patients, lower in Coeliac patients who had been following the gluten-free diet for over a year and lowest in newly diagnosed coeliac patients. Results of Study II show that Coeliac patients are troubled by a number of factors which include: the limited availability of gluten-free foods, presence of gluten in medications, food labeling, low availability of restaurants which cater for Coeliac patients both in the local scenario and abroad and future risk of developing malignancies. This study concludes that individuals suffering from Coeliac disease would greatly benefit from unified dietary guidelines, specific goals for the management of Coeliac disease and increased sensitivity to the psychological and emotional impact diagnosis and treatment has on such patients.