Relationship of premenstrual syndrome and diet compliance in celiac disease

Premenstrual syndrome (PMS) is a common health problem that occurs during the luteal period of the menstrual cycle and disappears with menstruation, and manifests itself with mental, behavioral and physical symptoms that negatively affect quality of life. Celiac disease (CD) is a disease that causes damage and inflammation in the small intestine and impairs nutrient absorption as a result of gluten consumption in genetically predisposed individuals. Given the known role of oxidative stress in the pathogenesis of PMS and the proven impact of diet on PMS, this study was designed to investigate the potential impact of CD on PMS symptoms. This hypothesis stems from the understanding that CD with its unique dietary restrictions, combined with the potential for malabsorption and increased oxidative stress when treatment adherence is not optimal, may contribute to the occurrence and severity of PMS. Our study aimed to investigate the relationship between dietary adherence and PMS in CDs. Dietary adherence was measured by different methods to increase the power of this study. Dietary adherence was assessed based on transglutaminase IgA levels, self-reports of individuals with CD and 72-hour diet list data. Based on these criteria, diet-compliant and non-compliant CD subjects were compared with healthy control subjects. PMS was assessed in the adolescents participating in the study using the premenstrual syndrome scale (PMSS) developed by Gençdoğan et al. In total, 50 CD and 42 healthy controls were evaluated. In the CD group, 31 patients and in the control group, 31 patients were evaluated as PMS according to the PMSS. As a result, it was found that the PMS scores of individuals with diet-incompliant CD were higher than those of diet-compliant individuals in the control group. This result was obtained consistently in the groups compared by all three methods. In the psychological, behavioral and physical subscales of the PMSS, it was observed that individuals with diet-incompliant CD had higher scores. It was thought that if individuals with CD do not comply with the diet, PMS increases due to inflammation in the intestine and thus increased oxidative stress in the body. In addition, dietary non-compliance was thought to affect these PMS scores by impairing nutrient absorption. Strict adherence to a gluten-free diet in individuals with CD may alleviate PMS symptoms. Therefore, it should be emphasized that patients should pay attention to their dietary compliance.