BACKGROUND & AIMS: Celiac disease (CD) patients often complain of symptoms 
consistent with gastroesophageal reflux disease (GERD). We aimed to assess the 
prevalence of GERD symptoms at diagnosis and to determine the impact of the 
gluten-free diet (GFD).
METHODS: We evaluated 133 adult CD patients at diagnosis and 70 healthy 
controls. Fifty-three patients completed questionnaires every 3 months during 
the first year and more than 4 years after diagnosis. GERD symptoms were 
evaluated using a subdimension of the Gastrointestinal Symptoms Rating Scale for 
heartburn and regurgitation domains.
RESULTS: At diagnosis, celiac patients had a significantly higher reflux symptom 
mean score than healthy controls (P < .001). At baseline, 30.1% of CD patients 
had moderate to severe GERD (score >3) compared with 5.7% of controls (P < .01). 
Moderate to severe symptoms were significantly associated with the classical 
clinical presentation of CD (35.0%) compared with atypical/silent cases (15.2%; 
P < .03). A rapid improvement was evidenced at 3 months after initial treatment 
with a GFD (P < .0001) with reflux scores comparable to healthy controls from 
this time point onward.
CONCLUSIONS: GERD symptoms are common in classically symptomatic untreated CD 
patients. The GFD is associated with a rapid and persistent improvement in 
reflux symptoms that resembles the healthy population.