Disclosures: The authors report no relevant financial disclosures.
September 12, 2020
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Celiac linked with increased IBS, functional constipation risk

Disclosures: The authors report no relevant financial disclosures.
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Children with celiac disease have a higher risk for irritable bowel syndrome and functional constipation even if they adhere to a gluten-free diet, according to study results.

Ruggiero Francavilla, MD, PhD, of the interdisciplinary department of medicine-pediatric section at the University of Bari in Italy, and colleagues wrote that current evidence suggests a connection between CD and functional abdominal pain disorders.

“Our group has shown that children presenting with IBS have a 4.2 times higher risk of having CD than children without IBS,” they wrote. “Moreover, the persistence of IBS-like symptoms irrespective to the rigorous adherence to a gluten-free diet and the demonstration of visceral hypersensitivity and dysmotility in CD patients further supports this association.”

Researchers conducted a prospective study of 417 patients (37% boys; mean age 13.7 years) with CD who had adhered to a strict GFD for more than 1 year and had negative results from serologic tests after starting the diet. Children and their parents filled out a questionnaire on gastrointestinal symptoms according to Rome IV criteria. Investigators use the patients’ closest siblings or cousins without CD as a control group (n = 373).

Francavilla and colleagues found a higher prevalence of functional abdominal pain disorders among patients with CD compared with controls (11.5% vs. 6.7%; P < .05). More specifically, they found a higher prevalence of IBS (7.2% vs. 3.2%; P < .05) and functional constipation (19.9% vs. 10.5%; P < .001) among these patients compared with controls.

In their analysis, researchers found that younger age (P < .05) and a higher level of anti-transglutaminase IgA at diagnosis (P < .04) were associated with functional abdominal pain disorders regardless of the duration of adherence to a GFD.

“The demonstration of a higher prevalence of IBS and FC in CD children should prompt an early detection of these conditions in order to anticipate its diagnoses and to program possible therapeutic interventions and educational programming,” Francavilla and colleagues wrote. “This approach will help to decrease the negative impact on daily functioning; improper health care utilization and personal search of therapeutic alternatives and improve quality of life.”