Celiac disease: small-bowel enteroclysis findings in adult patients treated with a gluten-free diet

H C van den Bosch, R T Tjon a Tham, A W Gooszen, J M Fauquenot-Nollen, C B Lamers
Radiology 1996, 201 (3): 803-8

PURPOSE: To correlate the radiologic, histopathologic, and clinical findings in patients with celiac disease after treatment with a glutenfree diet.

MATERIALS AND METHODS: Pretreatment and follow-up enteroclysis radiographs from 15 adult patients with known celiac disease were reviewed. Diagnosis of celiac disease was made at adult age. Changes in small-bowel morphology were determined by comparing enteroclysis findings before and after treatment with a gluten-free diet and were correlated with histopathologic and clinical findings.

RESULTS: Eight of 15 patients (group I) showed increased small-bowel abnormalities. All patients had increased symptoms, and all but one, whose condition had deteriorated, showed stable disease at biopsy. Group II patients (five of 15) showed improvement at follow-up enteroclysis. Biopsy findings showed improvement in small-bowel morphology in four patients and no change in one. Clinically, four patients showed improvement, and one had stable disease. Group III patients (two of 15) showed no change from initial to follow-up enteroclysis. Both showed partial atrophy, which was consistent with biopsy findings. In all patients, clinical symptoms correlated better with enteroclysis results (r = .48; P < .005) than they did with follow-up biopsy results (r = .18). True celiac disease-related malignancies and coexisting tumors occurred in 10 of 15 patients.

CONCLUSION: Enteroclysis appears to be more reliable than does biopsy in evaluation of response to a gluten-free diet in adults with celiac disease.

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