ASSOCIATION BETWEEN ADHERENCE TO GLUTEN-FREE DIET AND DUODENAL VILLUS RECOVERY ON ENDOSCOPY, IN PATIENTS WITH CELIAC DISEASE AND SEVERE DUODENAL ATROPHY FOR OVER 10 YEARS

Aims To evaluate the association between GFD and the recovery of SDA in patients with CD for over 10 years according to EGD criteria, confirmed on histology and serology.

Methods The initial sample consisted of 109 patients diagnosed with CD between 2005 and 2010 at the endoscopy service of Gastroclínica Cascavel (Paraná, Brazil), 53 of whom had SDA type III on EDG (Bonatto classification) confirmed on histology and serology. One patient died and 8 were lost to follow-up, leaving a final sample of 44 (83.01%), of whom 36 (81.81%) were women aged 30–68 years (mean: 50.47) and 8 were men (18.18%) aged 32–74 years (mean: 51.62). The patients were reevaluated after 10 years to test for correlations between adherence to GFD (a-d) and disease status.

Results Considering the sample of 44 patients, patients adhering to GFD experienced complete recovery of SDA on EGD and normal histological and serological findings (n = 25; 56.81%) or cross-contamination on EGD, with histologically confirmed foci of atrophy and normal serological findings (n = 9; 20.45%). Patients who adhered partly to GFD (voluntary gluten ingestion) were diagnosed with moderate atrophy on EGD, displayed atrophy on histology and had serological findings outside the normal range (n = 4; 9.09%). Patients with no gluten restriction displayed no change in relation to the original diagnosis of severe atrophy (n = 6; 13.63%).

Conclusions Esophagogastroduodenoscopy, confirmed by histology and serology, was efficient at evaluating the association between adherence to GFD and duodenal villus recovery according to the Bonatto classification (Bonatto et al., 2016): type III (severe atrophy), type II (partial atrophy), type I (foci of atrophy), and type 0 (complete recovery of villi).