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Recommendations Summary

CD: Assessment of Gastrointestinal Symptoms 2009

Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.


  • Recommendation(s)

    CD: Assess Gastrointestinal Symptoms

    The registered dietitian (RD) should assess gastrointestinal symptoms (such as type, frequency and volume of bowel function; abdominal pain and bloating; nausea or vomiting; reduced gut motility and delayed gastric emptying) in individuals with celiac disease. Several studies have reported that people with celiac disease (treated and untreated) are more likely to experience gastrointestinal symptoms than are healthy control subjects. 

    Rating: Strong
    Imperative

    • Risks/Harms of Implementing This Recommendation

      None.

    • Conditions of Application

      None specified.

    • Potential Costs Associated with Application

      Although costs of medical nutrition therapy (MNT) sessions and reimbursement vary, MNT sessions are essential for improved outcomes.

    • Recommendation Narrative

      • Several studies have reported that people with celiac disease (treated and untreated) are more likely to experience gastrointestinal symptoms such as diarrhea, constipation, abdominal pain and bloating, nausea or vomiting, reduced gut motility and delayed gastric emptying than are healthy control subjects (Cucchiara et al, 1995; Usai et al, 1995; Chiarioni et al, 1997; Fine et al, 1997; Benini et al, 2001; Cuomo et al, 2003; Midhagen et al, 2003; Tursi et al, 2003; Murray et al, 2004; Hopper et al, 2005; Viljamaa et al, 2005; Casellas et al, 2006)
      • Compliance with a gluten-free diet reduces the prevalence of these symptoms
      • Further evaluation of persistent gastrointestinal symptoms in some individuals with celiac disease is recommended. Evidence is limited regarding the effect of a gluten-free dietary pattern on indigestion, dysphagia and reflux; additional research is needed in these areas.

    • Recommendation Strength Rationale

      Conclusion statement received Grade II.

    • Minority Opinions

      Consensus reached.