Nutrition Management of Celiac Disease Improves Outcome of Patients
10.3969/j.issn.1674-9081.2015.04.004
- VernacularTitle:全程营养管理改善乳糜泻患者结局
- Author:
Rong-Rong LI
1
;
Kang YU
Author Information
1. 中国医学科学院 北京协和医学院 北京协和医院营养科
- Keywords:
gluten enteropathy;
celiac disease;
gluten-free diet;
nutrition management
- From:
Medical Journal of Peking Union Medical College Hospital
2015;(4):255-259
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate effect of comprehensive nutrition management on outcome of patients with celiac disease.Methods We retrospectively reviewed 17 consecutive patients with celiac disease diagnosed from January 2000 to December 2014 in Peking Union Medical College Hospital.Clinical features of these pa-tients were summarized.Nutrition management was implemented, involving gluten-free diet.Of these 17 pa-tients, 8 cases were followed up to assess their compliance and responses to nutrition management.Results The mean age of the recruited patients was (39.65 ±19.14) years.The male/female ratio was 9/8.All the patients were featured with chronic diarrhea of various severity, with 6 (35.29%) patients having steatorrhea ( positive sudan Ⅲstaining) and 7 (41.18%) patients showing positive occult blood in feces.Besides, low D-xylose ab-sorption (<1.2 g/5 h) was observed in 12 (70.59%) patients.The mean body mass index (BMI) at presen-tation was (16.57 ±3.05) kg/m2 .Twelve (70.59%) patients had malnutrition ( BMI<18.5 kg/m2 ) , inclu-ding 6 (35.29%) patients who had severe malnutrition ( BMI<15 kg/m2 ) .Hypoalbuminemia was present in 14 (82.35%) patients.Anemia was the most common extra-intestinal manifestation, found in 11 (64.71%) patients.Deficiency of iron, folate and vitamin B12 were confirmed in 6 ( 35.29%) , 3 ( 17.65%) , and 5 (29.41%) patients, respectively.Comprehensive nutrition management was administered to all the patients. Eight patients were followed up, with mean follow-up duration of (10.38 ±8.28) months (3-25 months) .Of the 8 patients, 7 were well compliant to nutrition management ( Likert scale scores 1-2) and had significant im-provement of diarrhea and abdominal distention, with body weight increasing from ( 44.83 ±9.77 ) kg before management to (47.17 ±9.30 ) kg ( P=0.681 ) and serum albumin elevating from ( 27.50 ±7.92 ) g/L at presentation to (34.20 ±3.27) g/L (P=0.102).Conclusion Patient education and comprehensive nutrition management with application of strict gluten-free diet, close follow-up, disease monitor, and guidance of dietary modification play a significant role in improving outcome and life quality of patients with celiac disease.
