engleski

Long-term influence of gluten free diet on physical and psychological development of children with coeliac disease

Coeliac disease has recently been redefined from chronic enteropathy to systemic disorder with gluten-induced manifestations and complications in different organs, presenting with a list of possible extraintestinal symptoms. Aims. We have therefore decided to investigate the long-term influence of adherence to gluten free diet (GFD) in our patients in respect to: i. their present body mass and weight, ii. presence of anaemia, iii. psychological status, iv. school performance. Methods. 56 patients with coeliac disease (mean age 12 y; average time after diagnosis 9 y) underwent physical examination and psychological testing. Also, their school performance was determined and blood taken to analyse endomysial antibodies (EMA) and red blood cell count. Adherence to GFD was established according to questionnaire and results of EMA testing. Results. 31 patient (55.3%) was on a strict GFD and had negative EMA. Out of 25 patients who were not on a strict GFD 13 (23.2%) were taking small amounts of gluten (4 or 33.3% of them EMA positive)while 12 (21.4%) were not on a diet (all EMA positive). According to our results: i. there is no significant difference in body mass and height in respect to adherence to GFD; ii. children on a strict GFD had significantly higher haemoglobin as well as mean cell haemoglobin (MCH) (p<0.05); iii. chronic fatigue was reported significantly lee frequent in patients on a strict GFD; iv. groups did not differ significantly in results of psychological testing (presence of mood changes, irritability, sleep disorders and decreased concentration) but, however, children on a GFD had better performance in school (p<0.1) than children who were not on a diet. Conclusion. We have shown that adherence to a strict GFD is essential for normal iron absorption and development of cognitive functions. Further studies are needed to evaluate the influence of GFD on psychological and amotional development of children.

coeliac disease; children; gluten free diet; physical development; psychological development

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