Introduction: Celiac disease (CD) is a chronic, immune-mediated small bowel enteropathy and gluten free diet (GFD) represents the only available treatment. Serological tests and duodenal biopsies are used to monitor patients’ adherence to GFD. We evaluated the performance of a new questionnaire namely “Milano questionnaire”.
Patients and Methods: The Milano questionnaire is composed of 9 items: 6 questions are based on a visual analogue scale while 3 of them are yes-no questions. Questions have been formulated in order to investigate the adherence to GFD, investigating voluntary and accidental gluten exposure. Two questions evaluate the presence and severity of symptoms experienced in case of gluten intake. Patients were divided in two groups according to the presence or absence of anti-transglutaminase antibodies.
Results: The Milano questionnaire was administered to 285 patients (209 females and 76 males) recruited from September 2015 to September 2016 at the Gastroenterology and Endoscopy Unit, IRCCS Ca’ Granda Foundation Ospedale Maggiore Policlinico of Milan. We observed a significant difference (p<0.005) in the score obtained with the Milano questionnaire in the two groups of patients. The 89% of enrolled patients presented normal values of anti-transglutaminase antibodies, while 11% remained positive. Dietary score obtained with the Milano questionnaire resulted significantly different in these two groups of patients highlighting a difference regarding attention on GFD. Lower scores were associated with higher probability of positivity of anti-transglutaminase antibodies (p< 0.05).
Conclusion: The Milano Questionnaire could be used together with serological levels of anti-transglutaminase antibodies, to evaluate compliance to the GFD, avoiding repetition of duodenal biopsies, invasive and poorly tolerated procedure.