Nutrition Management of Celiac Disease Improves Outcome of Patients

  Objective  To investigate effect of comprehensive nutrition management on outcome of patients with celiac disease.

  Methods  We retrospectively reviewed 17 consecutive patients with celiac disease diagnosed from January 2000 to December 2014 in Peking Union Medical College Hospital. Clinical features of these patients were summarized. Nutrition management was implemented, involving gluten-free diet. Of these 17 patients, 8 cases were followed up to assess their compliance and responses to nutrition management.

  Results  The mean age of the recruited patients was (39.65±19.14) years. The male/female ratio was 9/8. All the patients were featured with chronic diarrhea of various severity, with 6(35.29%) patients having steatorrhea (positive sudan Ⅲ staining) and 7(41.18%) patients showing positive occult blood in feces. Besides, low D-xylose absorption (< 1.2 g/5 h) was observed in 12(70.59%) patients. The mean body mass index (BMI) at presentation was (16.57±3.05)kg/m². Twelve (70.59%) patients had malnutrition (BMI < 18.5 kg/m²), including 6(35.29%) patients who had severe malnutrition (BMI < 15 kg/m²). Hypoalbuminemia was present in 14(82.35%) patients. Anemia was the most common extra-intestinal manifestation, found in 11(64.71%) patients. Deficiency of iron, folate and vitamin B₁₂ were confirmed in 6 (35.29%), 3 (17.65%), and 5 (29.41%) patients, respectively. Comprehensive nutrition management was administered to all the patients. Eight patients were followed up, with mean follow-up duration of (10.38±8.28) months (3-25 months). Of the 8 patients, 7 were well compliant to nutrition management (Likert scale scores 1-2) and had significant improvement of diarrhea and abdominal distention, with body weight increasing from (44.83±9.77)kg before management to (47.17±9.30)kg (P=0.681) and serum albumin elevating from (27.50±7.92)g/L at presentation to (34.20±3.27)g/L (P=0.102).

  Conclusion  Patient education and comprehensive nutrition management with application of strict gluten-free diet, close follow-up, disease monitor, and guidance of dietary modification play a significant role in improving outcome and life quality of patients with celiac disease.