Healthcare outcomes for early celiac disease screening
The clinical presentation of celiac disease varies. Many individuals are asymptomatic or present with extra-intestinal symptoms. Therefore, many sufferers remain undiagnosed.
Delayed diagnosis may lead to serious long-term complications, including poor growth and bone development in children, as well as osteoporosis and refractory celiac disease in adults. Early screening of at-risk groups may improve outcomes for celiac disease patients and prevent future complications. However, some health care professionals argue that the benefits of screening and early intervention do not outweigh the negative impacts of following a gluten-free diet on quality of life, particularly in asymptomatic individuals.
The purpose of this study was to investigate the health, quality of life, and dietary adherence in adult celiac disease patients diagnosed during childhood by screening compared to those diagnosed by clinical symptoms. Kivela et al. surveyed 237 adult celiac disease patients via a questionnaire. Health outcomes measured included symptoms, poor growth, anemia, hemoglobin levels, and degree of villous atrophy.
Of these participants, 48 (20%) were diagnosed by screening, while 188 (80%) were identified through presentation of clinical symptoms. The screen-diagnosed individuals tended to be identified at a significantly older age than those who were diagnosed via presentation of clinical symptoms. Health outcomes and quality of life were comparable between the two groups, and there was no difference in dietary adherence.
A subset of asymptomatic 27 screen-detected patients experienced increased anxiety about the dietary restrictions of celiac disease. This suggests that the absence of symptoms may make it more challenging to implement a gluten-free diet. It is important to note, however, that asymptomatic celiac disease patients are still at risk for developing long-term complications and should still adhere to a gluten-free diet.
The authors suggest that at-risk patient groups should be screened for celiac disease during childhood, as there were no differences in quality of life or dietary adherence for most individuals. Without screening, these individuals may remain undiagnosed for long periods of time and continue to experience the damaging health effects of consuming gluten, whether they are symptomatic or not.
http://journals.sagepub.com/doi/10.1177/2050640618778386
The purpose of this study was to investigate the health, quality of life, and dietary adherence in adult celiac disease patients diagnosed during childhood by screening compared to those diagnosed by clinical symptoms. Kivela et al. surveyed 237 adult celiac disease patients via a questionnaire. Health outcomes measured included symptoms, poor growth, anemia, hemoglobin levels, and degree of villous atrophy.
Of these participants, 48 (20%) were diagnosed by screening, while 188 (80%) were identified through presentation of clinical symptoms. The screen-diagnosed individuals tended to be identified at a significantly older age than those who were diagnosed via presentation of clinical symptoms. Health outcomes and quality of life were comparable between the two groups, and there was no difference in dietary adherence.
A subset of asymptomatic 27 screen-detected patients experienced increased anxiety about the dietary restrictions of celiac disease. This suggests that the absence of symptoms may make it more challenging to implement a gluten-free diet. It is important to note, however, that asymptomatic celiac disease patients are still at risk for developing long-term complications and should still adhere to a gluten-free diet.
The authors suggest that at-risk patient groups should be screened for celiac disease during childhood, as there were no differences in quality of life or dietary adherence for most individuals. Without screening, these individuals may remain undiagnosed for long periods of time and continue to experience the damaging health effects of consuming gluten, whether they are symptomatic or not.
http://journals.sagepub.com/doi/10.1177/2050640618778386
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