Endocrine Abstracts

Introduction

The only currently available treatment of coeliac disease is a gluten-free diet (GFD). It improves outcomes, and reduces health-care costs. However, adhering to a gluten-free diet is difficult for many people. The aim of this study is to evaluate the diet adherence in real life and his impact on disease evolution.

Patients and methods

This is a descriptive transversal study carried out over a period of 10 years. All patients with celiac disease were included.

Results

Forty one patients were included; the average age of patients was 36 years (17–75 years) with a sex ratio (M/F) equal to 0.46. The follow-up was assessed in 35 patients; the monitoring rhythm was 3 to 6 months according to the clinical state of the patient at the last visit. Diet adherence was limited to a few months after the introduction of the gluten-free diet in 37.1% of patients. Seventeen patients adhered to the diet during the follow-up period. A Non–observance to GFD was described in 5 patients. The main cause was the cost of it. Clinical improvement was noted in 20 patients after a mean delay of 3 months. Some cases of relapses (28.6%) were noted due to a poor gluten-free diet adherence. A normalization of celiac serology was noted in 44% of cases after an average delay of 34 months. Histologically, subtotal or total atrophy persisted in 10 patients.

Conclusion

Heightened awareness by patients can help maximize successful treatment, Routine follow-up is necessary to reinforce the need for a GFD, provide social and emotional support. Finally the role of associations should be encouraged to resolve financial problem.