Bowel symptoms, self-image and comorbidity impact on well-being of women with coeliac disease

Abstract

roos s, wilhelmsson s, vulcan a, sjöberg k & hallert c (2011)Journal of Nursing and Healthcare of Chronic Illness3, 302–309 Bowel symptoms, self-image and comorbidity impact on well-being of women with coeliac disease Aim. To explore if gastrointestinal (GI) symptoms, self-image and comorbidity are related to well-being in women with coeliac disease (CD) and whether a history of CD in childhood impacts on well-being in adulthood. Background. Women in Sweden living with CD show a reduced level of well-being and report a high rate of GI complaints for unclear reasons. The self-image of these women is unknown. Design. A cross-sectional survey of 231 Swedish women with CD on long-term treatment (≥5 years) with a gluten-free diet (GFD) was conducted in 2010. Results. The study showed that well-being is related to a high rate GI symptoms (OR 16·9, 95% CI 5·6–50·7), a negative self-image (OR 8·9, 95% CI 3·5–22·9) and comorbidity (OR 3·3, 95% CI 1·7–6·4). There was no impact of childhood symptoms on well-being, GI symptoms, self-image or comorbidity in adulthood. Half of the study population showed reduced well-being compared with norms. Practically all women (97%) declared that they were always or usually following a GFD and 62% reported at least one disease besides CD. Conclusion. The study demonstrated that the well-being of women living with CD is affected by GI complaints, self-image and a high rate of comorbidity whereas a history of signs and symptoms of CD in childhood not seems to impact on the well-being in adulthood. Relevance to clinical practice. Gastrointestinal symptoms, self-image and comorbidity are factors contributing to a low level of well-being of CD women living on a GFD. Launching a multi-disciplinary team for follow-up would represent a novel approach to support these women and may prove valuable in improving their subjective health.