Gastrointestinal symptoms rating scale in coeliac disease patients on wheat starch-based gluten-free diets

Background: A wheat starch-based gluten-free diet is widely adopted in the treatment of coeliac disease, even though the products contain trace amount s of gluten. The aim here was to establish whether such a diet sustains abd ominal symptoms. Methods: The Gastrointestinal Symptom Rating Scale (GSRS) was applied to 58 coeliac disease patients on gluten-free diets and 110 non -coeliac controls. An estimate was made of daily dietary fibre and wheat st arch-derived gluten. Psychological well-being was evaluated by a structured interview. Twenty-three coeliac patients consented to small-bowel biopsy. Results: The mean GSRS score in coeliac disease patients did not differ fro m that in control subjects. Poorer psychological well-being was associated with abdominal symptoms in coeliac patients, whereas the daily amount of wh eat starch had no effect on GSRS score. Overall dietary compliance was good , and villous atrophy was found in only 2 out of 23 patients. The average f ibre consumption, 13g per day, was lower than recommended. Conclusions: Whe at starch-based gluten-free products are well-tolerated in coeliac disease patients, provided that their diets are otherwise strict.