Clinico-Laboratory Assessment of Adherence to Gluten Free Diet among Children with Celiac disease

Authors: Mohsen S. Elalfy1, Mostafa A. A. El Hodhod1, Ahmad M. Hamdy1,Marwa T. El Deeb1, Noha M. Refaat2 and Dina A. E. Nbhan1

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Keywords: celiac disease – compliance – monitoring - Children


Introduction Celiac disease is a systemic immune-mediated disorder triggered by dietary gluten in genetically susceptible persons. Gluten is a protein complex found in wheat, rye, and barley. Celiac disease is characterized by a broad range of clinical presentations, a specific serum autoantibody response, and variable damage to the small intestinal mucosa predominately affecting the proximal small intestine

Aim of the study: Clinical and laboratory assessment of compliance of the patients to gluten free diet, and to determine the effect of education of the patients and their families on adherence to gluten free diet.

Patients and methods: A cross sectional study was conducted in Ain Shams University Children’s hospital in the period from July 2015 till July 2017, included 43 patients with celiac disease. Their ages ranged from 1.5 – 16 years, with median age of 6 years (5 – 11.5). They were 18 (41.9%) males, and 25 (58.1%) females. All patients were subjected to thorough medical history, Sociodemographic data, Detailed dietetic history using modified food frequency questionnaire, Barrier against gluten free diet History of disease control and Health-Related Quality of Life Assessment, thorough clinical examination including anthropometric measures and examination for abdominal distention. Laboratory workup included CBC, Attg IgA, Attg IgG and fecal gliadin. All the patients and their parents underwent an education program about strict adherence to gluten free diet lying stress to hidden gluten antigen

Results: The result of this study shows that an educational awareness program can increase the knowledge of CD patients in treatment. Increasing patients’ knowledge lead to improvements in patients’ health

Conclusion: Repeated counselling increased the level of adherence to GFD.