Quality of life in children with celiac disease: A paediatric cross-sectional study

Biagetti, Chiara; Gesuita, Rosaria; Gatti, Simona; Catassi, Carlo

doi:10.1016/j.dld.2015.07.009

Cited by 38 publications

(38 citation statements)

References 27 publications

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“…Consideration may be given to CD specific tools (51) . Parents, physicians and dietitians can all play a role in supporting positive eating behaviours and attitudes (12,18,19,46,(48)(49)(50)52) (Table 3).…”

Section: Discussionmentioning

confidence: 99%

Diminished quality of life among adolescents with coeliac disease using maladaptive eating behaviours to manage a gluten‐free diet: a cross‐sectional, mixed‐methods study

Cadenhead

Wolf

Lebwohl

et al. 2019

J Human Nutrition Diet

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Background Certain approaches to managing a strict gluten‐free diet (GFD) for coeliac disease (CD) may lead to impaired psychosocial well‐being, a diminished quality of life (QOL) and disordered eating. The present study aimed to understand adolescents’ approaches to managing a GFD and the association with QOL. Methods Thirty adolescents with CD (13–17 years old) following the GFD for at least 1 year completed the Celiac Dietary Adherence Test (CDAT) and QOL survey. Their approaches to GFD management were explored using a semi‐structured interview, where key themes were developed using an iterative process, and further analysed using a psychosocial rubric to classify management strategies and QOL. CDAT ratings were compared across groups. Results Gluten‐free diet management strategies were classified on a four‐point scale. Adaptive eating behaviours were characterised by greater flexibility (versus rigidity), trust (versus avoidance), confidence (versus controlling behaviour) and awareness (versus preoccupation) with respect to maintaining a GFD. Approximately half the sample (53.3%) expressed more maladaptive approaches to maintaining a GFD and those who did so were older with lower CD‐Specific Pediatric Quality of Life (CDPQOL) scores, mean subscale differences ranging from 15.0 points for Isolation (t = 2.4, P = 0.03, d.f. = 28) to 23.4 points for Limitations (t = 3.0, P = 0.01, d.f. = 28). Conclusions Adolescents with CD who manage a GFD with maladaptive eating behaviours similar to known risk factors for feeding and eating disorders experience diminished QOL. In accordance with CD management recommendations, we recommend ongoing follow‐up with gastroenterologists and dietitians and psychosocial support referrals, as needed.

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Section: Discussionmentioning

confidence: 99%

Diminished quality of life among adolescents with coeliac disease using maladaptive eating behaviours to manage a gluten‐free diet: a cross‐sectional, mixed‐methods study

Cadenhead

Wolf

Lebwohl

et al. 2019

J Human Nutrition Diet

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“…Untreated coeliac disease predisposes people to impaired quality of life due to different somatic and psychological symptoms . Accordingly, quality of life has been show to improve after the initiation of a gluten‐free diet in symptomatic patients , but this is less evident in screen‐detected patients who may already be comparable to the healthy population at diagnosis (Table ). There are concerns that the laboriousness and restrictive nature of the dietary treatment may actually lead to decreased quality of life in screen‐detected and asymptomatic individuals .…”

Section: Effects and Acceptance Of A Gluten‐free Dietmentioning

confidence: 99%

Screening for coeliac disease in children

Kivelä

Kurppa

2018

Acta Paediatrica

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“…Celiac disease (CD) is an immune-mediated systemic disorder triggered by ingested gluten and related prolamines in genetically susceptible individuals (Husby et al, 2012 ; Green et al, 2015 ). CD has progressively increased in prevalence and is associated with significant morbidity, impacting quality of life and health care costs (Biagetti et al, 2015 ; Burden et al, 2015 ; Catassi et al, 2015 ). Overall prevalence is nearly 1%, ranging from 0.3 to 5% in different regions (Catassi et al, 2015 ; Green et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Helicobacter pylori cagA+ Is Associated with Milder Duodenal Histological Changes in Chilean Celiac Patients

Lucero

Oyarzún

O’Ryan

et al. 2017

Front. Cell. Infect. Microbiol.

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HIGHLIGHTS What is already known about this subject?Celiac disease (CD) has a high clinical and histological diversity and the mechanisms underlying this phenomenon remain elusive.H. pylori is a bacterium that chronically infect gastric and duodenal mucosa activating both a Th1/Th17 and T-reg pathways.The role of H. pylori (and the effect of their virulence factors) in CD have not yet completely elucidated.What are the new findings?cagA+ H. pylori strains are associated to milder histological damage in infected CD patients.In active-CD patients the presence of cagA+ H. pylori is associated to an increase in T-reg markers, contrasting with a downregulation in cagA+ infected potential-CD individuals.How might it impact on clinical practice in the foreseeable future?The identification of microbiological factors that could modulate inflammation and clinical expression of CD may be used in the future as preventive strategies or as supplementary treatment in patients that cannot achieve complete remission, contributing to the better care of these patients.Background: Mechanisms underlying the high clinical and histological diversity of celiac disease (CD) remain elusive. Helicobacter pylori (Hp) chronically infects gastric and duodenal mucosa and has been associated with protection against some immune-mediated conditions, but its role (specifically of cagA+ strains) in CD is unclear.Objective: To assess the relationship between gastric Hp infection (cagA+ strains) and duodenal histological damage in patients with CD.Design: Case-control study including patients with active-CD, potential-CD and non-celiac individuals. Clinical presentation, HLA genotype, Hp/cagA gene detection in gastric mucosa, duodenal histology, Foxp3 positive cells and TGF-β expression in duodenal lamina propria were analyzed.Results: We recruited 116 patients, 29 active-CD, 37 potential-CD, and 50 non-CD controls. Hp detection was similar in the three groups (~30–40%), but cagA+ strains were more common in infected potential-CD than in active-CD (10/11 vs. 4/10; p = 0.020) and non-CD (10/20; p = 0.025). Among active-CD patients, Foxp3 positivity was significantly higher in subjects with cagA+ Hp+ compared to cagA- Hp+ (p < 0.01) and Hp- (p < 0.01). In cagA+ Hp+ individuals, Foxp3 positivity was also higher comparing active- to potential-CD (p < 0.01). TGF-β expression in duodenum was similar in active-CD with cagA+ Hp+ compared to Hp- and was significantly downregulated in cagA+ potential-CD subjects compared to other groups.Conclusion: Hp infection rates were similar among individuals with/without CD, but infection with cagA+ strains was associated with milder histological damage in celiac patients infected by Hp, and in active-CD cases with higher expression of T-reg markers. Results suggest that infection by cagA+ Hp may be protective for CD progression, or conversely, that these strains are prone to colonize intestinal mucosa with less severe damage.

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Quality of life in children with celiac disease: A paediatric cross-sectional study

Cited by 38 publications

References 27 publications

Diminished quality of life among adolescents with coeliac disease using maladaptive eating behaviours to manage a gluten‐free diet: a cross‐sectional, mixed‐methods study

Diminished quality of life among adolescents with coeliac disease using maladaptive eating behaviours to manage a gluten‐free diet: a cross‐sectional, mixed‐methods study

Screening for coeliac disease in children

Helicobacter pylori cagA+ Is Associated with Milder Duodenal Histological Changes in Chilean Celiac Patients

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