Gender-based differences and associated clinical manifestations and symptom severity of celiac disease: a 10-year retrospective study in a tertiary care center in Lebanon.

Authors

Hussein Fayyad-Kazan, Fatima Shaalan, Fatima Kdouh, Zainab Al-Hawraa Mchaymech, Youssef Alawieh, Mahdi Tarhini, Abdallah Medlej

Published in

Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology. Aug 30, 2026. Epub Aug 30, 2026.

Abstract

Celiac Disease (CD) is a systemic, immune-mediated disease triggered by dietary gluten in genetically predisposed individuals. It primarily affects the proximal small intestine and is accompanied by severe gastrointestinal and/or extra-intestinal manifestations. This study aimed to examine the frequency of clinical manifestations associated with CD, assess adherence rates to GFD and its effects on symptoms' resolution and overall improvement, and finally, to determine factors associated with disease symptom severity.
We conducted a 10-year retrospective analysis (2015-2024) of 1779 patients who presented to SRHUH with celiac disease symptoms, among whom 51 were biopsy-confirmed celiac disease cases. Data were collected from a comprehensive patient-completed questionnaire. Symptom severity was classified as Mild, Moderate, or Severe.
Among the biopsy-confirmed CD patients, 27.5% showed severe symptoms, and 82.4% were classified as Marsh 3C. While gastrointestinal manifestations were the most prevalent, CD patients also reported dental, neurological, musculoskeletal, cardiac, and psychiatric manifestations. Female patients showed significantly higher rates of nutritional supplement use, persistent symptoms after diagnosis, complications, anemia, and deficiencies in iron and vitamin D compared to males. In contrast, growth problems were significantly more common in males. In CD women, symptom severity was associated with medication use, headaches, peripheral neuropathy, bone/joint pain, muscle cramps, quality of life, and psychological state. Histologic severity (partial vs total villous atrophy) and anemia were not associated with symptom severity.
In this Lebanese tertiary-care cohort, CD predominantly affected adult females, with high rates of malabsorption-related complications and extra-intestinal complaints. Early diagnosis and dietary management may help mitigate disease progression and improve clinical outcomes.

PMID:
42669576
Bibliographic data and abstract were imported from PubMed on 31 Aug 2026.

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