Long-term deterioration of quality of life in adult patients with celiac disease is associated with treatment noncompliance

Dig Liver Dis. 2010 Oct;42(10):685-91. doi: 10.1016/j.dld.2010.03.004. Epub 2010 Apr 15.


Background: Deterioration of quality of life in the long term has been suggested for celiac disease patients on a gluten-free diet.

Aims: To determine long-term quality of life of celiac disease patients and to assess the benefits of gluten-free diet compliance.

Patients: We prospectively evaluated 53 newly diagnosed adult celiac disease patients.

Methods: The Short Form 36 Health Survey, the Gastrointestinal Symptoms Rating Scale and the Beck Depression Inventory were employed at the time of diagnosis, 1 year, and beyond 4 years (median: 53 months) on treatment.

Results: At 1 year, a significant improvement from baseline in quality of life indicators was observed (p<0.001 to p<0.0001) with comparable scores to healthy subjects. At 4 years, the Short Form 36 Health Survey scores (p<0.002 to p<0.0002) and Beck Depression Inventory score (p<0.002) show significant deterioration compare with 1 year. Most scores remained significantly better than those at diagnosis (p<0.03 to p<0.0005). No changes were detected in the Gastrointestinal Symptoms Rating Scale scores. The long-term impairment of quality of life was attributable to the deterioration of most dimensions in patients who were not strictly compliant with the gluten-free diet (p<0.05 to p<0.001).

Conclusions: Long-term deterioration of quality of life outcomes after the first year of gluten-free diet was associated with the lack of strict compliance with the diet.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Celiac Disease / diet therapy
  • Celiac Disease / psychology*
  • Diet, Gluten-Free*
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance*
  • Prospective Studies
  • Quality of Life*
  • Time Factors
  • Young Adult