Characteristics and factors related to quality of life in Mexican Mestizo patients with celiac disease

Abstract

BackgroundCeliac disease (CD) is a global health problem and its prevalence is underestimated, especially in Latin American populations. Our aim was to evaluate the clinical features, psychological factors, and health-related quality of life (QoL), before and after diagnosis, in a representative sample of adult Mexican Mestizo patients presenting with CD.MethodsA cross-sectional analysis was conducted on patients seen at two tertiary referral centers in Mexico. QoL before and after CD diagnosis was evaluated using the EuroQoL 5D, the Hospital Anxiety and Depression Scale (HADS), and the disease-specific Celiac Symptom Index (CSI) questionnaires.ResultsWe included 80 patients (80% were women, with a mean age of 48.6 ± 14.1 years). The most common symptoms were diarrhea (86%), bloating (77.5%), and abdominal pain (71.3%). Mean symptom duration was 10.33 ± 6.3 years. Fifty-one patients (63.8%) had a previous diagnosis of irritable bowel syndrome (IBS) and 23 (28.8%) had one of functional dyspepsia. Questionnaire respondents rated their health status at 50% before diagnosis (0 = worst imaginable state, 100 = best imaginable state) and there was a significant improvement of 26% after diagnosis. Thirty-nine percent of the patients had a CSI score > 45 and they were the ones that had been previously diagnosed most often with IBS (p = 0.13) or dyspepsia (p = .036).ConclusionsAt the time of diagnosis, Mexican Mestizo patients with CD had poor QoL. Long-standing symptoms and a previous diagnosis of functional disorders were associated with worse QoL. As in other populations, our results support the need for a detailed examination of cost-effective strategies for increasing CD awareness in clinical practice.

Health-related quality of life and determinant factors in celiac disease. A population-based analysis of adult patients in Spain

“…Studies based on the same instrument but used in other sociocultural contexts are rare, mostly because the original CD-QOL questionnaire was only validated in 2010. One study conducted on celiac patients in an area of New York (USA) which used the CD-QOL questionnaire found quality of life levels higher than those documented in our study (27), but other studies based on more generic instruments (e. g., the EuroQOL) (28) found lower HRQL levels in celiac patients than those observed in the New York series (29,30). Our results suggest that the HRQL found in the general population of adult celiac subjects may be lower than that observed in patients recruited in a hospital setting, giving rise to the hypothesis that periodic medical check-ups improve the quality in life for these patients by encouraging a stricter compliance with a gluten-free diet.…”

Determinant factors of quality of life in adult patients with eosinophilic esophagitis

“…A similar association has also been shown in patients with celiac disease, for which long-standing symptoms and a previous diagnosis of functional disorders were associated with worse HRQoL. 24,25 In fact, a diagnostic delay of up to six years from the onset of symptoms is commonly recognized in EoE, both in children and adults. 13,15 Based on these results, early diagnosis of the disease may help in resolving long-lasting QoL impairments in EoE.…”

Calidad de vida en adultos del Paraguay con enfermedad celiaca

“…La media del CD-QOL detectada (50,8±13,5) es similar a la obtenida por Rodríguez Almagro et al 15 , Ramírez-Cervantes et al 19 y Castilhos et al 18 con el mismo cuestionario. Este hallazgo es notable considerando que estos países son diferentes en muchos aspectos como el nivel socioeconómico y cultural 15 .…”

“…No obstante, en los Estados Unidos, la media detectada con el mismo cuestionario fue más elevada: 68,9 22 . Estableciendo puntos de corte propuestos por Casellas et al 17 se halló que la CVRS predominante fue la regular (49%), similar a los primeros autores citados 15,18,19 .…”

“…Este instrumento fue aplicado en el sur de Brasil obteniéndose buena calidad de vida en 75% de los encuestados 18 . En México, la CVRS fue buena en 75%, usando otro instrumento 19 .…”