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

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 percent. 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 percent 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 percent, only by intestinal biopsy in 17.5 percent, and by a combination of both methods in 70 percento. Conditions associated with CD were reported by 30 percent> of subjects and 20 percent> had relatives with CD. The GFD was strictly adhered to by 70 percent>, occasionally by 27 percent> and never by 3 percent>. Seventy five percent of subjects with a strict adherence to GFD had a favorable clinical response compared with 42 percent> of those with incomplete or lack of adherence (odds ratio 4.0, 95 percent> confidence intervals 2.8-5.7p < 0.01). Conclusions: In 30 percent 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 percent> did not experience a clinical improvement despite a strict GFD, a finding which requires further study.