Quality of Life in Celiac Disease

Abstract

Celiac disease (CD) is a systemic immune disorder whose only treatment is a gluten-free diet (GFD). Its chronic nature, together with the restrictions imposed by the restrictive and permanent diet, can have a considerable negative impact on the health-related quality of life (HRQoL) of CD patients and their families. To objectively assess HRQoL, validated questionnaires should be used. In this chapter, studies performed using validated generic and specific questionnaires have been reviewed. Most studies show that before starting the GFD, recently diagnosed children and adult CD patients have a worse HRQoL than the general population, although, after one year of treatment with a GFD, their HRQoL is similar to that of the general population. However, adults’ HRQoL is not completely normalized, probably due to the social and emotional effects of following a strict diet. Children score their general HRQoL as “good” when it is assessed with different generic questionnaires and the specific CDPQOL, whereas they consider as “neutral” when it is assessed using the specific CDDUX. When children’s and parents’ opinion are assessed, in general parents evaluate their children´s HRQoL worse than the children themselves. As a result, in the opinion of most authors, it is interesting to assess both point of views. In children and adults, the main factors related to having a worse HRQoL are dietary non-adherence and having social and/or economic difficulties, related to following the GFD. In summary, adult celiac patients and both, celiac children and their parents, feel that the disease have no substantial negative impacts on patients’ HRQOL.