Original Article

Can the Mucosa Heal Histologically in Celiac Disease? What are the Indicators of Remission in Celiac Patients?

Volume 36 · Issue 8 Publish Date: April 7, 2025
Berat Ebik ORCID Ferhat Bacaksiz ORCID Mustafa Zanyar Akkuzu ORCID Ahmet Yavuz ORCID Ümit Karabulut ORCID Muhsin Kaya ORCID
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Published In

Turkish Journal of Gastroenterology

Volume 36 · Issue 8

Pages: 523-530

History

Published Online: April 7, 2025

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright © 2025 Berat Ebik, Ferhat Bacaksiz, Mustafa Zanyar Akkuzu, Ahmet Yavuz, Ümit Karabulut, Muhsin Kaya

Berat Ebik ORCID
Division of Gastroenterology, University of Health Sciences, Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Türkiye
Ferhat Bacaksiz ORCID
Division of Gastroenterology, University of Health Sciences, Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Türkiye
Mustafa Zanyar Akkuzu ORCID
Division of Gastroenterology, University of Health Sciences, Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Türkiye
Ahmet Yavuz ORCID
Department of Gastroenterology, Dicle University School of Medicine, Diyarbakır, Türkiye
Ümit Karabulut ORCID
Department of Gastroenterology, Dicle University School of Medicine, Diyarbakır, Türkiye
Muhsin Kaya ORCID
Department of Gastroenterology, Dicle University School of Medicine, Diyarbakır, Türkiye
Ebik, B., Bacaksiz, F., Zanyar Akkuzu, M., Yavuz, A., Karabulut, Ümit, & Kaya, M. (2025). Can the Mucosa Heal Histologically in Celiac Disease? What are the Indicators of Remission in Celiac Patients?. Turkish Journal of Gastroenterology, 36(8), 523–530. https://doi.org/10.5152/tjg.2025.24518
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Abstract

Background/Aims: The effect of a gluten-free diet on the small intestinal mucosa in patients with celiac disease (CD) is unclear. The occurrence of mucosal healing and the permanence of villous atrophy in celiac patients under a gluten-free diet were investigated.

Materials and Methods: The symptoms, laboratory values, autoantibody levels, and endoscopic mucosal biopsy samples of 115 celiac patients, 56 of whom were in remission at different time periods since diagnosis, were examined.

Results: Although 61.8% of patients said they were compliant with the gluten-free diet, 48.7% were in remission. Sixty-seven percent (n = 77) of patients with CD reported at least one symptom. Only weight loss was associated with disease activity (P = .019). While only 5 (8.9%) of the patients in remission were endoscopically and histopathologically normal, villous atrophy was detected in 69.9% of the patients. Villous atrophy was present in 86% of patients within the first 5 years of diagnosis, while this rate was 59% in patients older than 10 years. Logistic regression analysis showed that compliance with diet (odds ratio [OR]: 4.39; P < .001) and normal endoscopic appearance of the mucosa (OR: 13.01; P < .001) were the strongest predictive factors of remission.

Conclusion: Diet compliance and remission rates of celiac patients increase over time. However, histologically, intraepithelial lymphocy tosis almost never improves, and villous atrophy persists in most patients even if they comply with the diet. Although the asymptomatic nature of the patients, their autoantibody titers, and their dietary compliance are considered important indicators of remission, these parameters do not clearly reflect the histological status of the mucosa.

 

Cite this article as: Ebik B, Bacaksiz F, Akkuzu MZ, Yavuz A, Karabulut Ü, Kaya M. Can the mucosa heal histologically in celiac
disease? What are the indicators of remission in celiac patients? Turk J Gastroenterol. 2025;36(8):523-530.

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Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 36 · Issue 8
Pages 523-530
DOI 10.5152/tjg.2025.24518
History
Published Online April 7, 2025
License
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright
Copyright (c) 2025 Berat Ebik, Ferhat Bacaksiz, Mustafa Zanyar Akkuzu, Ahmet Yavuz, Ümit Karabulut, Muhsin Kaya
Affiliations
Berat Ebik ORCID
Division of Gastroenterology, University of Health Sciences, Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Türkiye
Ferhat Bacaksiz ORCID
Division of Gastroenterology, University of Health Sciences, Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Türkiye
Mustafa Zanyar Akkuzu ORCID
Division of Gastroenterology, University of Health Sciences, Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Türkiye
Ahmet Yavuz ORCID
Department of Gastroenterology, Dicle University School of Medicine, Diyarbakır, Türkiye
Ümit Karabulut ORCID
Department of Gastroenterology, Dicle University School of Medicine, Diyarbakır, Türkiye
Muhsin Kaya ORCID
Department of Gastroenterology, Dicle University School of Medicine, Diyarbakır, Türkiye
Cite this Article
Ebik, B., Bacaksiz, F., Zanyar Akkuzu, M., Yavuz, A., Karabulut, Ümit, & Kaya, M. (2025). Can the Mucosa Heal Histologically in Celiac Disease? What are the Indicators of Remission in Celiac Patients?. Turkish Journal of Gastroenterology, 36(8), 523–530. https://doi.org/10.5152/tjg.2025.24518
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