Poster Presentation International Celiac Disease Symposium 2026

Socioeconomic factors associated with symptom burden among Canadians living with celiac disease (#326)

Caleigh McAulay 1 , James A King 2 , Melissa Secord 1 , M. Ines Pinto-Sanchez 3 , Justine M Turner 4 , Dominica Gidrewicz 2 , Shelley Case 1 , Donald R Duerksen 5
  1. Celiac Canada, Mississauga, ON, Canada
  2. University of Calgary, Calgary, AB, Canada
  3. McMaster University, Hamilton, ON, Canada
  4. University of Alberta, Edmonton, AB, Canada
  5. University of Manitoba, Winnipeg, MB, Canada

Background: There has been a growing recognition of the diverse presentations in celiac disease (CeD). Accordingly, it is worthwhile to understand if and how patient-level factors are associated with the degree of symptom types and their resolution after diagnosis.

Methods: An online survey for Canadians affected by CeD was conducted in 2022, with information collected on domains such as demographics, symptoms, diagnosis, and management of the gluten-free diet (GFD). Cumulative link models were fit to estimate the association between respondent factors (e.g., gender, urban/rural status, income) with the number of symptoms experienced prior to diagnosis across three categories: gastrointestinal, extraintestinal, and neurological. Models were also fit to estimate the likelihood of symptoms persisting among the three most common symptoms per category after initiation of the GFD. Models were adjusted for age, time since diagnosis, and comorbidities.

Results: Among 6260 respondents, there were increased odds of having more symptoms among females compared to males across all three symptom categories (all p<0.01). Females were also more likely than males to have common symptoms persist after diagnosis such as bloating, weakness/tiredness, iron deficiency, bone/joint pain, and anxiety (all p<0.01). Lower income levels were also associated with a greater number of symptoms prior to diagnosis (all p<0.01) and increased likelihood of having bloating, abdominal pain, weakness/tiredness, bone/joint pain, and brain fog persist following diagnosis (all p<0.01). More symptoms before diagnosis were also observed as rurality increased (all p<0.01) and those living in rural areas were more likely to have continued weakness/tiredness, bone/joint pain, and brain fog after diagnosis (all p<0.01).

Discussion: Several socioeconomic factors are associated with a greater number of reported symptoms prior to CeD diagnosis as well as persistence of symptoms after initiating treatment. Greater focus on providing support for those at increased risk of symptom-related burden is recommended.