Washington DC [US], Dec. 1 : Even after strict adherence to a gluten-free diet, nearly one in five kids with celiac disease sustain persistent intestinal damage, reports a study.

The article has been published in the journal of Pediatric Gastroenterology and Nutrition.

Findings were also consistent in adults, which showed that more than 33 percent of adult patients on a gluten-free diet have persistent intestinal damage, despite a reduction of symptoms or the results of blood tests.

"The number of children who don't heal on the gluten-free diet was much higher than expected," said Alessio Fasano, co-senior author of the study.

"We assumed that healing would occur once a patient was put on the gluten-free diet. Now that we have learned that this is not the case for all celiac patients, we are changing our clinical practice by repeating the endoscopy after one year of the implementation of the gluten-free diet," Fasano explained.

The study was based on a retrospective examination of the biopsy and medical records of 103 children with celiac disease treated at MassGeneral Hospital for Children (MGHfC) and Boston Children's Hospital (BCH) in New York.

Most pediatric patients were over the age of 10 and were monitored for mucosal healing with a repeat endoscopy, along with follow-up blood testing, after one year of treatment with the gluten-free diet.

The children were on gluten-free diet for one year and were determined by dietitians and other hospital health care practitioners to have complied well with the diet.

The biopsies found the persistent intestinal damage in 19 percent of the children.

Another finding that surprised Fasano was that blood levels of the autoantibody IgA tTG - the primary lab test used to monitor celiac disease - did not accurately measure mucosal recovery.

"Malabsorption (imperfect absorption of food material by the small intestine) and inflammation in children may have negative repercussions on physical and cognitive development," the authors noted.

Although the long-term risks for children with persistent intestinal damage are not clear, such damage in adults has been linked to an increased risk of lymphoma, low bone density and fracture. (ANI)