{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:58:29Z","timestamp":1791979109148,"version":"4.4.0"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T00:00:00Z","timestamp":1641859200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T00:00:00Z","timestamp":1641859200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Liver and gastrointestinal diseases research center, Tabriz University of medical sciences, Tabriz, Iran"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In this trial, we investigated the effect of a group-based education program on gastrointestinal (GI) symptoms and quality of life (QOL) in patients with celiac disease (CD).\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Method<\/jats:title>\n                <jats:p>In the present study, 130 patients with CD who were on a GFD for at least 3\u00a0months, randomly assigned to receive group-based education (<jats:italic>n<\/jats:italic>\u2009=\u200966) or routine education in the celiac clinic (<jats:italic>n<\/jats:italic>\u2009=\u200964) for 3\u00a0months. We assessed gastrointestinal symptoms and quality of life using the gastrointestinal symptom rating scale (GSRS) questionnaire and SF-36 questionnaire at baseline and 3\u00a0months after interventions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The mean age of the participants was 37.57\u2009\u00b1\u20099.59\u00a0years. There were no significant differences between the two groups regarding the baseline values. Results showed that the mean score of total GSRS score in the intervention group was significantly lower compared with the control group 3\u00a0months post-intervention (<jats:italic>p<\/jats:italic>\u2009=\u20090.04). Also, there was a significant difference in the mean score of SF-36 between the two groups 3\u00a0months post-intervention (<jats:italic>p<\/jats:italic>\u2009=\u20090.02).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Results showed that group-based education was an effective intervention in patients with celiac disease to improve gastrointestinal symptoms and quality of life.<\/jats:p>\n                <jats:p><jats:italic>Trial registration<\/jats:italic> IRCT code: IRCT20080904001197N21; registration date: 5\/23\/2019.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12876-022-02096-1","type":"journal-article","created":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T11:02:45Z","timestamp":1641898965000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The effect of group-based education on gastrointestinal symptoms and quality of life in patients with celiac disease: randomized controlled clinical trial"],"prefix":"10.1186","volume":"22","author":[{"given":"Zahra","family":"Akbari Namvar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Mahdavi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masood","family":"Shirmohammadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeinab","family":"Nikniaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,1,11]]},"reference":[{"key":"2096_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2012\/654143","volume":"2012","author":"T Pozo-Rubio","year":"2012","unstructured":"Pozo-Rubio T, Olivares M, Nova E, De Palma G, Mujico JR, Ferrer MD, et al. Immune development and intestinal microbiota in celiac disease. Clin Dev Immunol. 2012;2012:1\u201312.","journal-title":"Clin Dev Immunol"},{"issue":"1","key":"2096_CR2","first-page":"5","volume":"3","author":"MR Nejad","year":"2011","unstructured":"Nejad MR, Rostami K, Emami MH, Zali MR, Malekzadeh R. Epidemiology of celiac disease in Iran: a review. Middle East J Dig Dis. 2011;3(1):5.","journal-title":"Middle East J Dig Dis"},{"issue":"1","key":"2096_CR3","first-page":"1","volume":"13","author":"P Makovicky","year":"2020","unstructured":"Makovicky P, Makovicky P, Caja F, Rimarova K, Samasca G, Vannucci L. Celiac disease and gluten-free diet: past, present, and future. Gastroenterol Hepatol Bed Bench. 2020;13(1):1.","journal-title":"Gastroenterol Hepatol Bed Bench"},{"issue":"2","key":"2096_CR4","doi-asserted-by":"publisher","first-page":"341","DOI":"10.3390\/nu12020341","volume":"12","author":"R Borghini","year":"2020","unstructured":"Borghini R, Porpora MG, Casale R, Marino M, Palmieri E, Greco N, et al. Irritable bowel syndrome-like disorders in endometriosis: prevalence of nickel sensitivity and effects of a low-nickel diet. An open-label pilot study. Nutrients. 2020;12(2):341.","journal-title":"Nutrients"},{"issue":"8","key":"2096_CR5","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.3390\/nu10081015","volume":"10","author":"P Laurikka","year":"2018","unstructured":"Laurikka P, Nurminen S, Kivel\u00e4 L, Kurppa K. Extraintestinal manifestations of celiac disease: early detection for better long-term outcomes. Nutrients. 2018;10(8):1015.","journal-title":"Nutrients"},{"issue":"25","key":"2096_CR6","doi-asserted-by":"publisher","first-page":"2419","DOI":"10.1056\/NEJMcp1113994","volume":"367","author":"A Fasano","year":"2012","unstructured":"Fasano A, Catassi C. Celiac disease. N Engl J Med. 2012;367(25):2419\u201326.","journal-title":"N Engl J Med"},{"issue":"8","key":"2096_CR7","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.1136\/gutjnl-2013-306578","volume":"63","author":"JF Ludvigsson","year":"2014","unstructured":"Ludvigsson JF, Bai JC, Biagi F, Card TR, Ciacci C, Ciclitira PJ, et al. Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology. Gut. 2014;63(8):1210\u201328.","journal-title":"Gut"},{"issue":"6","key":"2096_CR8","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1111\/cch.12271","volume":"41","author":"ME McGrady","year":"2015","unstructured":"McGrady ME, Ryan JL, Guti\u00e9rrez-Colina AM, Fredericks EM, Towner EK, Pai AL. The impact of effective paediatric adherence promotion interventions: systematic review and meta-analysis. Child Care Health Dev. 2015;41(6):789\u2013802.","journal-title":"Child Care Health Dev"},{"issue":"6","key":"2096_CR9","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1093\/jpepsy\/jsm128","volume":"33","author":"S Kahana","year":"2008","unstructured":"Kahana S, Drotar D, Frazier T. Meta-analysis of psychological interventions to promote adherence to treatment in pediatric chronic health conditions. J Pediatr Psychol. 2008;33(6):590\u2013611.","journal-title":"J Pediatr Psychol"},{"issue":"4","key":"2096_CR10","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1097\/MPG.0000000000002604","volume":"70","author":"Z Nikniaz","year":"2020","unstructured":"Nikniaz Z, Abbasalizad Farhangi M, Nikniaz L. Systematic review with meta-analysis of the health-related quality of life in children with celiac disease. J Pediatr Gastroenterol Nutr. 2020;70(4):468\u201377.","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"9279","key":"2096_CR11","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1016\/S0140-6736(01)05554-4","volume":"358","author":"G Corrao","year":"2001","unstructured":"Corrao G, Corazza GR, Bagnardi V, Brusco G, Ciacci C, Cottone M, et al. Mortality in patients with coeliac disease and their relatives: a cohort study. The Lancet. 2001;358(9279):356\u201361.","journal-title":"The Lancet"},{"issue":"2","key":"2096_CR12","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1016\/j.appet.2011.01.026","volume":"56","author":"K Sainsbury","year":"2011","unstructured":"Sainsbury K, Mullan B. Measuring beliefs about gluten free diet adherence in adult coeliac disease using the theory of planned behaviour. Appetite. 2011;56(2):476\u201383.","journal-title":"Appetite"},{"issue":"8","key":"2096_CR13","doi-asserted-by":"publisher","first-page":"2300","DOI":"10.3390\/nu12082300","volume":"12","author":"K G\u0142ady\u015b","year":"2020","unstructured":"G\u0142ady\u015b K, Dardzi\u0144ska J, Guzek M, Adrych K, Ma\u0142gorzewicz S. Celiac dietary adherence test and standardized dietician evaluation in assessment of adherence to a gluten-free diet in patients with celiac disease. Nutrients. 2020;12(8):2300.","journal-title":"Nutrients"},{"issue":"5","key":"2096_CR14","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1038\/ajg.2013.47","volume":"108","author":"K Sainsbury","year":"2013","unstructured":"Sainsbury K, Mullan B, Sharpe L. A randomized controlled trial of an online intervention to improve gluten-free diet adherence in celiac disease. Am J Gastroenterol ACG. 2013;108(5):811\u20137.","journal-title":"Am J Gastroenterol ACG."},{"issue":"5","key":"2096_CR15","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1097\/SGA.0000000000000575","volume":"44","author":"M Akhavan Sabbagh","year":"2021","unstructured":"Akhavan Sabbagh M, Mahdavi R, Shirmohammadi M, Nikniaz Z. Barriers of adherence to a gluten-free diet in iranian adults with celiac disease. Gastroenterol Nurs. 2021;44(5):320\u20137.","journal-title":"Gastroenterol Nurs"},{"issue":"5","key":"2096_CR16","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1038\/ajg.2013.47","volume":"108","author":"K Sainsbury","year":"2013","unstructured":"Sainsbury K, Mullan B, Sharpe L. A randomized controlled trial of an online intervention to improve gluten-free diet adherence in celiac disease. Am J Gastroenterol. 2013;108(5):811\u20137.","journal-title":"Am J Gastroenterol"},{"key":"2096_CR17","doi-asserted-by":"crossref","unstructured":"Nikniaz Z, Shirmohammadi M, Akbari Namvar Z. Development and effectiveness assessment of a Persianlanguage smartphone application for celiac patients: A randomized controlled clinical trial. Patient Educ Couns. 2021;104(2):337\u201342.","DOI":"10.1016\/j.pec.2020.08.014"},{"key":"2096_CR18","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.jpeds.2017.02.062","volume":"185","author":"K Haas","year":"2017","unstructured":"Haas K, Martin A, Park K. Text message intervention (TEACH) improves quality of life and patient activation in celiac disease: a randomized clinical trial. J Pediatr. 2017;185:62\u20137.","journal-title":"J Pediatr"},{"key":"2096_CR19","unstructured":"Organization WH. Peer Support Programmes in Diabetes: Report of a WHO Consultation, 5\u20137 November 2007. Geneva: WHO. 2008:1-22."},{"issue":"2","key":"2096_CR20","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1093\/her\/18.2.191","volume":"18","author":"H Cooper","year":"2003","unstructured":"Cooper H, Booth K, Gill G. Patients\u2019 perspectives on diabetes health care education. Health Educ Res. 2003;18(2):191\u2013206.","journal-title":"Health Educ Res"},{"issue":"6","key":"2096_CR21","doi-asserted-by":"publisher","first-page":"499","DOI":"10.5001\/omj.2017.95","volume":"32","author":"H Habibzadeh","year":"2017","unstructured":"Habibzadeh H, Sofiani A, Alilu L, Gillespie M. The effect of group discussion-based education on self-management of adults with type 2 diabetes mellitus compared with usual care: A randomized control trial. Oman Med J. 2017;32(6):499.","journal-title":"Oman Med J"},{"issue":"4","key":"2096_CR22","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1097\/MEG.0b013e3283333b61","volume":"22","author":"G Ringstr\u00f6m","year":"2010","unstructured":"Ringstr\u00f6m G, St\u00f6rsrud S, Posserud I, Lundqvist S, Westman B, Simr\u00e9n M. Structured patient education is superior to written information in the management of patients with irritable bowel syndrome: a randomized controlled study. Eur J Gastroenterol Hepatol. 2010;22(4):420\u20138.","journal-title":"Eur J Gastroenterol Hepatol"},{"issue":"6","key":"2096_CR23","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1111\/jhn.12318","volume":"28","author":"L Whigham","year":"2015","unstructured":"Whigham L, Joyce T, Harper G, Irving P, Staudacher HM, Whelan K, et al. Clinical effectiveness and economic costs of group versus one-to-one education for short-chain fermentable carbohydrate restriction (low FODMAP diet) in the management of irritable bowel syndrome. J Hum Nutr Diet. 2015;28(6):687\u201396.","journal-title":"J Hum Nutr Diet"},{"issue":"3","key":"2096_CR24","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1097\/SGA.0b013e318255fe3a","volume":"35","author":"LR Jacobsson","year":"2012","unstructured":"Jacobsson LR, Friedrichsen M, G\u00f6ransson A, Hallert C. Impact of an active patient education program on gastrointestinal symptoms in women with celiac disease following a gluten-free diet: a randomized controlled trial. Gastroenterol Nurs. 2012;35(3):200\u20136.","journal-title":"Gastroenterol Nurs"},{"issue":"1","key":"2096_CR25","doi-asserted-by":"publisher","first-page":"e00121","DOI":"10.14309\/ctg.0000000000000121","volume":"11","author":"A Rej","year":"2020","unstructured":"Rej A, Trott N, Kurien M, Branchi F, Richman E, Subramanian S, et al. Is peer support in group clinics as effective as traditional individual appointments? The first study in patients with celiac disease. Clin Transl Gastroenterol. 2020;11(1):e00121.","journal-title":"Clin Transl Gastroenterol"},{"key":"2096_CR26","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1007\/s12529-020-09949-7","volume":"28","author":"Z Akbari Namvar","year":"2021","unstructured":"Akbari Namvar Z, Mahdavi R, Shirmohammadi M, Nikniaz Z. The effect of group-based education on knowledge and adherence to a gluten-free diet in patients with celiac disease: randomized controlled clinical trial. Int J Behav Med. 2021;28:583\u201390.","journal-title":"Int J Behav Med"},{"issue":"1","key":"2096_CR27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1745-6215-11-32","volume":"11","author":"KF Schulz","year":"2010","unstructured":"Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Trials. 2010;11(1):1\u20138.","journal-title":"Trials"},{"issue":"1","key":"2096_CR28","first-page":"18","volume":"17","author":"M Mazaheri","year":"2012","unstructured":"Mazaheri M, SadatKhoshouei M. Comparison between psychometric characteristics of persian version of the gastrointestinal symptoms rating scale in functional gastrointestinal disorders and normal groups. Govaresh. 2012;17(1):18\u201324.","journal-title":"Govaresh"},{"issue":"12","key":"2096_CR29","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1097\/MEG.0b013e3282f163dc","volume":"19","author":"J Urnes","year":"2007","unstructured":"Urnes J, Farup PG, Lydersen S, Petersen H. Patient education in gastro-oesophageal reflux disease: a randomized controlled trial. Eur J Gastroenterol Hepatol. 2007;19(12):1104\u201310.","journal-title":"Eur J Gastroenterol Hepatol"},{"issue":"4","key":"2096_CR30","doi-asserted-by":"publisher","first-page":"107","DOI":"10.3390\/microorganisms6040107","volume":"6","author":"ME Obrenovich","year":"2018","unstructured":"Obrenovich ME. Leaky gut, leaky brain? Microorganisms. 2018;6(4):107.","journal-title":"Microorganisms"},{"issue":"4","key":"2096_CR31","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1208\/s12248-017-0076-6","volume":"19","author":"JJ Lochhead","year":"2017","unstructured":"Lochhead JJ, Ronaldson PT, Davis TP. Hypoxic stress and inflammatory pain disrupt blood-brain barrier tight junctions: implications for drug delivery to the central nervous system. AAPS J. 2017;19(4):910\u201320.","journal-title":"AAPS J"},{"issue":"2","key":"2096_CR32","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.jpsychores.2012.11.007","volume":"74","author":"NJ van Hees","year":"2013","unstructured":"van Hees NJ, Van der Does W, Giltay EJ. Coeliac disease, diet adherence and depressive symptoms. J Psychosom Res. 2013;74(2):155\u201360.","journal-title":"J Psychosom Res"},{"issue":"6","key":"2096_CR33","doi-asserted-by":"publisher","first-page":"1438","DOI":"10.1007\/s10620-018-4936-4","volume":"63","author":"RL Wolf","year":"2018","unstructured":"Wolf RL, Lebwohl B, Lee AR, Zybert P, Reilly NR, Cadenhead J, et al. Hypervigilance to a gluten-free diet and decreased quality of life in teenagers and adults with celiac disease. Dig Dis Sci. 2018;63(6):1438\u201348.","journal-title":"Dig Dis Sci"},{"issue":"5\u20136","key":"2096_CR34","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1111\/j.1365-2702.2011.03953.x","volume":"21","author":"L Ring Jacobsson","year":"2012","unstructured":"Ring Jacobsson L, Friedrichsen M, G\u00f6ransson A, Hallert C. Does a Coeliac School increase psychological well-being in women suffering from coeliac disease, living on a gluten-free diet? J Clin Nurs. 2012;21(5\u20136):766\u201375.","journal-title":"J Clin Nurs"},{"issue":"7","key":"2096_CR35","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1080\/00365520310003309","volume":"38","author":"K Larsson","year":"2003","unstructured":"Larsson K, Karlbom U, Nordin K, Anderberg U, L\u00f6\u00f6f L. A group-based patient education programme for high-anxiety patients with Crohn disease or ulcerative colitis. Scand J Gastroenterol. 2003;38(7):763\u20139.","journal-title":"Scand J Gastroenterol"},{"issue":"1","key":"2096_CR36","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1159\/000186144","volume":"2","author":"V Paul-Ebhohimhen","year":"2009","unstructured":"Paul-Ebhohimhen V, Avenell A. A systematic review of the effectiveness of group versus individual treatments for adult obesity. Obes Facts. 2009;2(1):17\u201324.","journal-title":"Obes Facts"},{"issue":"1","key":"2096_CR37","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s12955-021-01694-z","volume":"19","author":"Z Nikniaz","year":"2021","unstructured":"Nikniaz Z, Asghari Jafarabadi M, Ghaffarifar S, Ravand Z, Akbari Namvar Z, Shirmohammadi M. The Persian Translation and validation of the celiac disease quality of life questionnaire (CDQOL). Health Qual Life Outcomes. 2021;19(1):52.","journal-title":"Health Qual Life Outcomes"}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-022-02096-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-022-02096-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-022-02096-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T11:03:05Z","timestamp":1641898985000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-022-02096-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,11]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["2096"],"URL":"https:\/\/doi.org\/10.1186\/s12876-022-02096-1","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,11]]},"assertion":[{"value":"15 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 January 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 January 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The protocol of this study was accepted by the ethics committee of Tabriz University of Medical Sciences (IR.TBZMED.REC.1398.075) and all methods were performed in accordance with declaration of Helsinki. Patients signed written informed consent before participation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"18"}}