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Encuesta nacional online aplicada en pacientes con enfermedad celíaca en Chile A national online survey applied to patients with celiac disease in Chile

Keywords: Biopsy , Celiac disease , Diet , gluten free

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Abstract:

Background: Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten in genetically susceptible individuals. Its prevalence in Europe and the USA is 0.5 to 1%. Aim: To analyze epidemiological aspects and degree of compliance with gluten-free diet (GFD) among Chilean individuals with CD. Material and Methods: Subjects with confirmed or suspected CD were invited to answer an online survey published on the web at www.fundacionconvivir.cl. The answers were reinforced with a telephone interview. Results: The survey was answered by 1212 subjects (79% females). Median age at diagnosis was 25.8 years (range 1 to 84 years), with a bimodal curve with two peaks at less than 3 years and at 20 to 40 years of age. The diagnosis was made only by serologic markers in 9%, only by intestinal biopsy in 17.5%, and by a combination of both methods in 70%o. Conditions associated with CD were reported by 30%> of subjects and 20%> had relatives with CD. The GFD was strictly adhered to by 70%>, occasionally by 27%> and never by 3%>. Seventy five percent of subjects with a strict adherence to GFD had a favorable clinical response compared with 42%> of those with incomplete or lack of adherence (odds ratio 4.0, 95%> confidence intervals 2.8-5.7p < 0.01). Conclusions: In 30% of respondents, the diagnosis of CD was not confirmed according to international guidelines that require serology and duodenal biopsy. One third of subjects recognized a poor compliance with GFD. Those with a strict adherence to it had a more favorable clinical course. However, 25%> did not experience a clinical improvement despite a strict GFD, a finding which requires further study.

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