Research Article
Ege Üniversitesi Tıp Fakültesi Öğrencilerinde Çölyak Hastalığı Taraması Ve Çölyak Farkındalığı Çalışması
Abstract
Amaç: Dünya genelinde yaklaşık %1’lik bir prevelansa sahip olan çölyak hastalığı, ülkemizde de sık görülmekte ancak tanıda gözden kaçabilmektedir. Asemptomatik çölyak hastalığının yetişkin bireylerde daha sık görülmesi de tanıyı zorlaştırmaktadır. Bu nedenle çölyak hastalığının farkındalığını arttırmak ve hastalığının farkında olmayan bireylerin tanı almasını sağlamak amacıyla Ege Üniversitesi Tıp Fakültesi bünyesinde bir anket ve bilgilendirme çalışması düzenlenmiştir.
Gereç ve Yöntem: Çalışmamızda yaklaşık 550 tıp fakültesi öğrencisine ayrıntılı çölyak semptom anketi uygulanmış ve semptom pozitifliği belirlenen 110 birey Ege Üniversitesi Tıp Fakültesi Gastroenteroloji Kliniği’ne davet edilmiştir.
Bulgular: Davetler sonucunda yalnızca 36 kişi kliniğimize ziyaret gerçekleştirmiştir. Bu ziyaretler esnasında hastaların anemnezleri sonrası serumlarında çölyak antikorları incelenmiştir. Çalışma sonucunda çölyak ilişkili klinik bulgular ve riskler göstermelerine rağmen hiçbir hastada çölyak serolojisine rastlanmamıştır. Bu kişilerin ilerleyen dönemlerde semptom pozitifliği devam etmesi durumunda tekrar kliniğe davet edilmeleri planlanmıştır. Ayrıca bu kişilerin çölyak dışı gluten intoleranslarının olabileceği düşünülmüştür.
Sonuç: Ülkemizde tıp fakültesi öğrencileri arasında ilk defa gerçekleştirilen çölyak semptom taraması çalışmasının, ilerleyen dönemlerde merkez kampüs kapsamında genişletilerek tekrarlanması planlanmaktadır. Bunların dışında, yapılan bu çalışma ile tıp fakültesi öğrencilerinin sahip olduğu birçok hastalık ve tıbbi şikâyetin sıklıklarına yönelik veriler elde edilmiştir.
Keywords
References
- Fasano A, Catassi C. Clinical practice. Celiac disease. N Engl J Med. 2012;367(25):2419–26.
- Jericho H, Sansotta N, Guandalini S. Extraintestinal Manifestations of Celiac Disease: Effectiveness of the Gluten-Free Diet. J Pediatr Gastroenterol Nutr. 2017;65(1):75–9.
- West J, Logan RFA, Smith CJ, Hubbard RB, Card TR. Malignancy and mortality in people with coeliac disease: population based cohort study. BMJ. 2004;329(7468):716–8.
- Shaker JL, Brickner RC, Findling JW, Kelly TM, Rapp R, Rizk G, et al. Hypocalcemia and skeletal disease as presenting features of celiac disease. Arch Intern Med. 1997;157(9):1013-6.
- Cosnes J, Cellier C, Viola S, Colombel JF, Michaud L, Sarles J, et al. Incidence of autoimmune diseases in celiac disease: protective effect of the gluten-free diet. Clin Gastroenterol Hepatol. 2008;6(7):753–8.
- Therrien A, Kelly CP, Silvester JA. Celiac Disease: Extraintestinal Manifestations and Associated Conditions. J Clin Gastroenterol. 2020;54(1):8–21.
- Singh P, Arora A, Strand TA, Leffler DA, Catassi C, Green PH, et al. Global Prevalence of Celiac Disease: Systematic Review and Meta-analysis. Clinical Gastroenterology and Hepatology. 2018;16(6):823-836.e2.
- Dalgic B, Sari S, Basturk B, Ensari A, Egritas O, Bukulmez A, et al. Prevalence of celiac disease in healthy Turkish school children. Am J Gastroenterol. 2011;106(8):1512–7.
- Gursoy S, Guven K, Simsek T, Yurci A, Torun E, Koc N, et al. The prevalence of unrecognized adult celiac disease in Central Anatolia. J Clin Gastroenterol. 2005;39(6):508–11.
- Freeman HJ. Endocrine manifestations in celiac disease. World J Gastroenterol. 2016;22(38):8472.
- Hujoel IA, Reilly NR, Rubio-Tapia A. Celiac Disease: Clinical Features and Diagnosis. Gastroenterol Clin North Am. 2019;48(1):19–37.
- Goyal O, Nohria S, Dhaliwal AS, Goyal P, Soni RK, Chhina RS, et al. Prevalence, overlap, and risk factors for Rome IV functional gastrointestinal disorders among college students in northern India. Indian J Gastroenterol. 2021;40(2):144–53.
- Giuffrè M, Gazzin S, Zoratti C, Llido JP, Lanza G, Tiribelli C, et al. Celiac Disease and Neurological Manifestations: From Gluten to Neuroinflammation. Int J Mol Sci. 2022;23(24).
- Hadjivassiliou M, Sanders DD, Aeschlimann DP. Gluten-related disorders: gluten ataxia. Dig Dis. 2015;33(2):264–8.
- Chin RL, Sander HW, Brannagan TH, Green PHR, Hays AP, Alaedini A, et al. Celiac neuropathy. Neurology. 2003;60(10):1581–5.
- Mearns ES, Taylor A, Thomas Craig KJ, Puglielli S, Cichewicz AB, Leffler DA, et al. Neurological Manifestations of Neuropathy and Ataxia in Celiac Disease: A Systematic Review. Nutrients. 2019;11(2).
- Pennisi M, Bramanti A, Cantone M, Pennisi G, Bella R, Lanza G. Neurophysiology of the ‘Celiac Brain’: Disentangling Gut-Brain Connections. Front Neurosci. 2017;11.
- Hadjivassiliou M, Grünewald RA, Lawden M, Davies-Jones GAB, Powell T, Smith CML. Headache and CNS white matter abnormalities associated with gluten sensitivity. Neurology. 2001;56(3):385–8.
- Ghorbani A, Abtahi SM, Fereidan-Esfahani M, Abtahi SH, Shemshaki H, Akbari M, et al. Prevalence and clinical characteristics of headache among medical students, Isfahan, Iran. J Res Med Sci. 2013;18(Suppl 1):S24.
- Balaban H, Semiz M, Senturk IA, Kavakci O, Cinar Z, Dikici A, et al. Migraine prevalence, alexithymia, and post-traumatic stress disorder among medical students in Turkey. J Headache Pain. 2012;13(6):459–67.
- Addolorato G, Capristo E, Ghittoni G, Valeri C, Mascianà R, Ancona C, et al. Anxiety but not depression decreases in coeliac patients after one-year gluten-free diet: a longitudinal study. Scand J Gastroenterol. 2001;36(5):502–6.
- Bushara KO. Neurologic presentation of celiac disease. Gastroenterology. 2005;128(4 SUPPL. 1).
- Carta MG, Hardoy MC, Usai P, Carpiniello B, Angst J. Recurrent brief depression in celiac disease. J Psychosom Res. 2003;55(6):573–4.
- Yelland GW, Gregory Yelland CW. Gluten-induced cognitive impairment (“brain fog”) in coeliac disease. J Gastroenterol Hepatol. 2017;32:90–3.
- Kumar B, Shah MAA, Kumari R, Kumar A, Kumar J, Tahir A. Depression, Anxiety, and Stress Among Final year Medical Students. Cureus. 2019;11(3
- Alvi T AFRMKFA. Depression, Anxiety and Their Associated Factors Among Medical Students. Journal of the College of Physicians and Surgeons Pakistan. 2010;20(2):122–6.
- Rehmani N, Khan Q ul A, Fatima SS. Stress, Anxiety and Depression in students of a private medical school in Karachi, Pakistan. Pak J Med Sci. 2018;34(3):696–701.
- Bykova SV, Sabel'nikova EA, Parfenov AI, Gudkova RB, Krums LM, Chikunova BZ. Reproductive disorders in women with celiac disease. Effect of the etiotropic therapy. Eksp Klin Gastroenterol. 2011;(3):12-8 (Russian).
- Tersigni C, Castellani R, De waure C, Fattorossi A, De Spirito M, Gasbarrini A, et al. Celiac disease and reproductive disorders: meta-analysis of epidemiologic associations and potential pathogenic mechanisms. Hum Reprod Update. 2014;20(4):582–93.
- Kwak Y, Kim Y, Baek KA. Prevalence of irregular menstruation according to socioeconomic status: A population-based nationwide cross-sectional study. PLoS One. 2019;14(3).
- Bae J, Park S, Kwon JW. Factors associated with menstrual cycle irregularity and menopause. BMC Womens Health. 2018;18(1).
- Öz Gül Ö, Şahı̇n S, Cander S, Gül B, Kaan ÜNAL O, Akçali Ü, et al. Endokrinoloji Polikliniğine Başvuran Hastalarda Tiroid Fonksiyonlarının Yaş ile Olan İlişkisinin İncelenmesi. Uludağ Tıp Derg. 2011;37(2):67-70.
- Ventura A, Ronsoni MF, Shiozawa MBC, Dantas-Corrêa EB, Canalli MHB da S, Schiavon L de L, et al. Prevalence and clinical features of celiac disease in patients with autoimmune thyroiditis: cross-sectional study. Sao Paulo Medical Journal. 2014;132(6):364–71.
- Lerner A, Jeremias P, Matthias T. Gut-thyroid axis and celiac disease. Endocr Connect. 2017;6(4):R52–8.
- Al-Toma A, Volta U, Auricchio R, Castillejo G, Sanders DS, Cellier C, et al. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterol J. 2019;7(5):583–613.
- Ludvigsson JF, Murray JA. Epidemiology of Celiac Disease. Gastroenterol Clin North Am. 2019;48(1):1–18.
- Losurdo G, Di Leo M, Santamato E, Arena M, Rendina M, Luigiano C, et al. Serologic diagnosis of celiac disease: May it be suitable for adults? World J Gastroenterol. 2021;27(42):7233–9.
- Barbaro MR, Cremon C, Wrona D, Fuschi D, Marasco G, Stanghellini V, et al. Non-Celiac Gluten Sensitivity in the Context of Functional Gastrointestinal Disorders. Nutrients. 2020;12(12):3735.
Year 2024,
, 297 - 309, 10.06.2024
Abstract
Aim: Celiac disease, which has a global prevalence of approximately 1%, is also common in our country; however, it can often go undiagnosed. The higher occurrence of asymptomatic celiac disease in adult individuals further complicates diagnosis. Therefore, with the aim of increasing awareness of celiac disease and ensuring that individuals unaware of the disease receive a diagnosis, a survey and information campaign were organized within Ege University Faculty of Medicine.
Materials and Methods: In our study, a detailed celiac symptom survey was administered to approximately 550 medical faculty students, and 110 individuals with positive symptoms were invited to the Ege University Faculty of Medicine Gastroenterology Clinic.
Results: As a result of these invitations, only 36 individuals visited our clinic. During these visits, celiac antibodies in their sera were examined after taking their medical history. The study found that, despite showing clinical symptoms and risk factors associated with celiac disease, none of the patients had celiac serology. These individuals are planned to be invited to the clinic again if they continue to exhibit positive symptoms in the future. Additionally, it is considered that these individuals may have non-celiac gluten intolerance.
Conclusion: This celiac symptom screening study, which is conducted for the first time among medical faculty students in our country, is planned to be expanded and repeated in the central campus in the future. In addition, this study has provided data on the frequencies of many diseases and medical complaints that medical faculty students may have.
References
- Fasano A, Catassi C. Clinical practice. Celiac disease. N Engl J Med. 2012;367(25):2419–26.
- Jericho H, Sansotta N, Guandalini S. Extraintestinal Manifestations of Celiac Disease: Effectiveness of the Gluten-Free Diet. J Pediatr Gastroenterol Nutr. 2017;65(1):75–9.
- West J, Logan RFA, Smith CJ, Hubbard RB, Card TR. Malignancy and mortality in people with coeliac disease: population based cohort study. BMJ. 2004;329(7468):716–8.
- Shaker JL, Brickner RC, Findling JW, Kelly TM, Rapp R, Rizk G, et al. Hypocalcemia and skeletal disease as presenting features of celiac disease. Arch Intern Med. 1997;157(9):1013-6.
- Cosnes J, Cellier C, Viola S, Colombel JF, Michaud L, Sarles J, et al. Incidence of autoimmune diseases in celiac disease: protective effect of the gluten-free diet. Clin Gastroenterol Hepatol. 2008;6(7):753–8.
- Therrien A, Kelly CP, Silvester JA. Celiac Disease: Extraintestinal Manifestations and Associated Conditions. J Clin Gastroenterol. 2020;54(1):8–21.
- Singh P, Arora A, Strand TA, Leffler DA, Catassi C, Green PH, et al. Global Prevalence of Celiac Disease: Systematic Review and Meta-analysis. Clinical Gastroenterology and Hepatology. 2018;16(6):823-836.e2.
- Dalgic B, Sari S, Basturk B, Ensari A, Egritas O, Bukulmez A, et al. Prevalence of celiac disease in healthy Turkish school children. Am J Gastroenterol. 2011;106(8):1512–7.
- Gursoy S, Guven K, Simsek T, Yurci A, Torun E, Koc N, et al. The prevalence of unrecognized adult celiac disease in Central Anatolia. J Clin Gastroenterol. 2005;39(6):508–11.
- Freeman HJ. Endocrine manifestations in celiac disease. World J Gastroenterol. 2016;22(38):8472.
- Hujoel IA, Reilly NR, Rubio-Tapia A. Celiac Disease: Clinical Features and Diagnosis. Gastroenterol Clin North Am. 2019;48(1):19–37.
- Goyal O, Nohria S, Dhaliwal AS, Goyal P, Soni RK, Chhina RS, et al. Prevalence, overlap, and risk factors for Rome IV functional gastrointestinal disorders among college students in northern India. Indian J Gastroenterol. 2021;40(2):144–53.
- Giuffrè M, Gazzin S, Zoratti C, Llido JP, Lanza G, Tiribelli C, et al. Celiac Disease and Neurological Manifestations: From Gluten to Neuroinflammation. Int J Mol Sci. 2022;23(24).
- Hadjivassiliou M, Sanders DD, Aeschlimann DP. Gluten-related disorders: gluten ataxia. Dig Dis. 2015;33(2):264–8.
- Chin RL, Sander HW, Brannagan TH, Green PHR, Hays AP, Alaedini A, et al. Celiac neuropathy. Neurology. 2003;60(10):1581–5.
- Mearns ES, Taylor A, Thomas Craig KJ, Puglielli S, Cichewicz AB, Leffler DA, et al. Neurological Manifestations of Neuropathy and Ataxia in Celiac Disease: A Systematic Review. Nutrients. 2019;11(2).
- Pennisi M, Bramanti A, Cantone M, Pennisi G, Bella R, Lanza G. Neurophysiology of the ‘Celiac Brain’: Disentangling Gut-Brain Connections. Front Neurosci. 2017;11.
- Hadjivassiliou M, Grünewald RA, Lawden M, Davies-Jones GAB, Powell T, Smith CML. Headache and CNS white matter abnormalities associated with gluten sensitivity. Neurology. 2001;56(3):385–8.
- Ghorbani A, Abtahi SM, Fereidan-Esfahani M, Abtahi SH, Shemshaki H, Akbari M, et al. Prevalence and clinical characteristics of headache among medical students, Isfahan, Iran. J Res Med Sci. 2013;18(Suppl 1):S24.
- Balaban H, Semiz M, Senturk IA, Kavakci O, Cinar Z, Dikici A, et al. Migraine prevalence, alexithymia, and post-traumatic stress disorder among medical students in Turkey. J Headache Pain. 2012;13(6):459–67.
- Addolorato G, Capristo E, Ghittoni G, Valeri C, Mascianà R, Ancona C, et al. Anxiety but not depression decreases in coeliac patients after one-year gluten-free diet: a longitudinal study. Scand J Gastroenterol. 2001;36(5):502–6.
- Bushara KO. Neurologic presentation of celiac disease. Gastroenterology. 2005;128(4 SUPPL. 1).
- Carta MG, Hardoy MC, Usai P, Carpiniello B, Angst J. Recurrent brief depression in celiac disease. J Psychosom Res. 2003;55(6):573–4.
- Yelland GW, Gregory Yelland CW. Gluten-induced cognitive impairment (“brain fog”) in coeliac disease. J Gastroenterol Hepatol. 2017;32:90–3.
- Kumar B, Shah MAA, Kumari R, Kumar A, Kumar J, Tahir A. Depression, Anxiety, and Stress Among Final year Medical Students. Cureus. 2019;11(3
- Alvi T AFRMKFA. Depression, Anxiety and Their Associated Factors Among Medical Students. Journal of the College of Physicians and Surgeons Pakistan. 2010;20(2):122–6.
- Rehmani N, Khan Q ul A, Fatima SS. Stress, Anxiety and Depression in students of a private medical school in Karachi, Pakistan. Pak J Med Sci. 2018;34(3):696–701.
- Bykova SV, Sabel'nikova EA, Parfenov AI, Gudkova RB, Krums LM, Chikunova BZ. Reproductive disorders in women with celiac disease. Effect of the etiotropic therapy. Eksp Klin Gastroenterol. 2011;(3):12-8 (Russian).
- Tersigni C, Castellani R, De waure C, Fattorossi A, De Spirito M, Gasbarrini A, et al. Celiac disease and reproductive disorders: meta-analysis of epidemiologic associations and potential pathogenic mechanisms. Hum Reprod Update. 2014;20(4):582–93.
- Kwak Y, Kim Y, Baek KA. Prevalence of irregular menstruation according to socioeconomic status: A population-based nationwide cross-sectional study. PLoS One. 2019;14(3).
- Bae J, Park S, Kwon JW. Factors associated with menstrual cycle irregularity and menopause. BMC Womens Health. 2018;18(1).
- Öz Gül Ö, Şahı̇n S, Cander S, Gül B, Kaan ÜNAL O, Akçali Ü, et al. Endokrinoloji Polikliniğine Başvuran Hastalarda Tiroid Fonksiyonlarının Yaş ile Olan İlişkisinin İncelenmesi. Uludağ Tıp Derg. 2011;37(2):67-70.
- Ventura A, Ronsoni MF, Shiozawa MBC, Dantas-Corrêa EB, Canalli MHB da S, Schiavon L de L, et al. Prevalence and clinical features of celiac disease in patients with autoimmune thyroiditis: cross-sectional study. Sao Paulo Medical Journal. 2014;132(6):364–71.
- Lerner A, Jeremias P, Matthias T. Gut-thyroid axis and celiac disease. Endocr Connect. 2017;6(4):R52–8.
- Al-Toma A, Volta U, Auricchio R, Castillejo G, Sanders DS, Cellier C, et al. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterol J. 2019;7(5):583–613.
- Ludvigsson JF, Murray JA. Epidemiology of Celiac Disease. Gastroenterol Clin North Am. 2019;48(1):1–18.
- Losurdo G, Di Leo M, Santamato E, Arena M, Rendina M, Luigiano C, et al. Serologic diagnosis of celiac disease: May it be suitable for adults? World J Gastroenterol. 2021;27(42):7233–9.
- Barbaro MR, Cremon C, Wrona D, Fuschi D, Marasco G, Stanghellini V, et al. Non-Celiac Gluten Sensitivity in the Context of Functional Gastrointestinal Disorders. Nutrients. 2020;12(12):3735.
There are 38 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Gastroenterology and Hepatology |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | June 10, 2024 |
| Submission Date | October 25, 2023 |
| Acceptance Date | December 5, 2023 |
| Published in Issue | Year 2024 |