Characteristics and factors related to quality of life in Mexican Mestizo patients with celiac disease

Background: Celiac disease (CD) is a global health problem and its prevalence is underestimated, especially in Latin American populations. Our aim was to evaluate the clinical features, psychological factors, and health-related quality of life (QoL), before and after diagnosis, in a representative sample of adult Mexican Mestizo patients presenting with CD. Methods: A cross-sectional analysis was conducted on patients seen at two tertiary referral centers in Mexico. QoL before and after CD diagnosis was evaluated using the EuroQoL 5D, the Hospital Anxiety and Depression Scale (HADS), and the disease-specific Celiac Symptom Index (CSI) questionnaires. Results: We included 80 patients (80% were women, with a mean age of 48.6 +/- 14.1 years). The most common symptoms were diarrhea (86%), bloating (77.5%), and abdominal pain (71.3%). Mean symptom duration was 10.33 +/- 6.3 years. Fifty-one patients (63.8%) had a previous diagnosis of irritable bowel syndrome (IBS) and 23 (28.8%) had one of functional dyspepsia. Questionnaire respondents rated their health status at 50% before diagnosis (0 = worst imaginable state, 100 = best imaginable state) and there was a significant improvement of 26% after diagnosis. Thirty-nine percent of the patients had a CSI score > 45 and they were the ones that had been previously diagnosed most often with IBS (p = 0.13) or dyspepsia (p = .036). Conclusions: At the time of diagnosis, Mexican Mestizo patients with CD had poor QoL. Long-standing symptoms and a previous diagnosis of functional disorders were associated with worse QoL. As in other populations, our results support the need for a detailed examination of cost-effective strategies for increasing CD awareness in clinical practice.