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).
