Reflux oesophagitis in adult coeliac disease: beneficial effect of a gluten free diet. Issue 4 (1st April 2003)

• Record Type: Journal Article
• Authors: Cuomo, A; Romano, M; Rocco, A; Budillon, G; Del Vecchio Blanco, C; Nardone, G
• Is Part Of: Gut. Volume 52:Issue 4(2003)
• Page Start: 514
• Page End: 517
• Publication Date: 2003-04-01
• Subjects: coeliac disease -- reflux oesophagitis -- gluten free diet; GORD, gastro-oesophageal reflux disease -- LOS, lower oesophageal sphincter -- EMA, endomysium antibodies; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gut.52.4.514
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Background: Coeliac disease patients show a number of gastrointestinal motor abnormalities, including a decrease in lower oesophageal sphincter pressure. The prevalence of endoscopic oesophagitis in these subjects however is unknown. Aim: To evaluate whether untreated adult coeliac patients had an increased prevalence of reflux oesophagitis and, if so, to assess whether a gluten free diet exerted any beneficial effect on gastro-oesophageal reflux disease (GORD) symptoms. Patients and methods: We retrospectively studied 205 coeliac patients (females/males 153/52, median age 32 years) who underwent endoscopy for duodenal biopsy and 400 non-coeliac subjects (females/males 244/156, median age 37 years) referred for endoscopy for upper gastrointestinal symptoms. Each patient was given a questionnaire for evaluation of GORD symptoms prior to and 4–12 months after endoscopy. Coeliac patients were given a gluten free diet. Oesophagitis patients of both groups, following an eight week course of omeprazole, were re-evaluated for GORD symptoms at four month intervals up to one year. Significance of differences was assessed by Fisher's exact test. Results: Oesophagitis was present in 39/205 (19%, 95% confidence interval (CI) 13.8–25.0%) coeliac patients and in 32/400 (8%, 95% CI 5.5–11.1%) dyspeptic subjects. At the one year follow up, GORD symptoms relapsed in 10/39 (25.6%, 95% CI 13–42.1%) coeliacs with oesophagitis and in 23/32 (71.8%, 95% CI 53.2–86.2%) non-coeliac subjects with oesophagitis. Conclusion: Coeliac patients have a high prevalence of reflux oesophagitis. That a gluten free diet significantly decreased the relapse rate of GORD symptoms suggests that coeliac disease may represent a risk factor for development of reflux oesophagitis.