Gastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet.

Nachman F, Vázquez H, González A, Andrenacci P, Compagni L, Reyes H, Sugai E, Moreno ML, Smecuol E, Hwang HJ, Sánchez IP, Mauriño E, Bai JC.

Department of Medicine; Dr. C. Bonorino Udaondo Gastroenterology Hospital; Buenos Aires; Argentina.
Abstract

BACKGROUNDS & AIM:: Celiac disease (CD) patients often complain of symptoms consistent with gastroesophageal reflux disease (GERD). We aimed to assess the prevalence of GERD symptoms at diagnosis and to determine the impact of the gluten-free diet (GFD). METHODS:: We evaluated 133 adult CD patients at diagnosis and 70 healthy controls. Fifty-three patients completed questionnaires every three months during the first year and more than 4 years after diagnosis. GERD symptoms were evaluated using a sub-dimension of the Gastrointestinal Symptoms Rating Scale for heartburn and regurgitation domains. RESULTS:: At diagnosis, celiac patients had a significantly higher reflux symptom mean score than healthy controls (p <0.001). At baseline, 30.1% of CD patients had moderate to severe GERD (score >3) compared with 5.7% of controls (p <0.01). Moderate to severe symptoms were significantly associated with the classical clinical presentation of CD (35.0%) compared with atypical/silent cases (15.2%, p <0.03). A rapid improvement was evidenced at 3 months after initiate treatment with a GFD (p <0.0001) with reflux scores comparable to healthy controls from this time point onward. CONCLUSION:: GERD symptoms are common in classically symptomatic untreated CD patients. The GFD is associated with a rapid and persistent improvement in reflux symptoms that resembles the healthy population. Copyright © 2010 AGA Institute. Published by Elsevier Inc. All rights reserved. PMID: 20601132 [PubMed - as supplied by publisher]