Quality of life in screen-detected and typical coeliac disease and the effect of excluding dietary gluten

Objective It is widely recognized that 'asymptomatic' patients with coeliac disease often feel better after commencing a gluten-free diet. The aim of this study was to determine a measure of the quality of life in patients diagnosed as having coeliac disease detected both by screening and those with typical clinical symptoms. Methods Quality of life (QoL) was measured using the SF36 questionnaire. This was completed prospectively by all subjects who agreed to undergo duodenal biopsy as a follow-up to a serological screening programme. Seventeen typical coeliac patients who presented clinically also completed the QoL assessment at diagnosis. Both coeliac groups were compared to healthy controls. SF36 questionnaires and coeliac serology were repeated in coeliac patients after 1 year on a gluten-free diet. Results There were no significant differences between the eight SF36 parameters when the screen-detected coeliac patients were compared to controls, and at 1 year follow-up compared to their baseline data. Two QoL parameters (general health, vitality) improved significantly in the typical coeliac patients at 1 year follow-up compared to their baseline data. General health with reference to 1 year previously significantly improved in typical coeliac patients (3.8 vs 2.2; P = 0.0004) but not screen-detected coeliac patients (2.9 vs 2.4; P = 0.08). Conclusions Quality of life in screen-detected coeliac patients did not differ significantly compared to controls. Two of eight QoL parameters improved significantly in typical coeliac patients compared to baseline data. Dietary gluten exclusion in typical coeliac patients led to a significant improvement in health at 1 year follow-up, in contrast to screen-detected coeliac patients. (C) 2004 Lippincott Williams Wilkins.