High Rates of Microscopic Colitis in Celiac Disease, Especially Among Middle Aged Women

Celiac.com 07/27/2011 - Based on associations made between microscopic colitis and celiac disease in scientific literature, but limited population-based data, a team of researchers set out to assess rates of microscopic colitis in celiac disease.

The research team included M. Stewart, C. N. Andrews, S. Urbanski, P. L. Beck, and M. Storr. They were looking to better understand how these two diseases might be connected, and to identify any factors that might cause them to occur together.

This led them to conduct a population-based review of all people diagnosed with celiac disease and microscopic colitis in a large Canadian medical center over a 5-year period.

To do that, they searched endoscopy and pathology databases to find all diagnosis made for celiac disease and microscopic colitis within the Calgary Health Region between 2004 and 2008.

To get accurate results, they made sure to standardize age and gender data from their study with 2006 Canadian Census data.

They then used standardized incidence ratios (SIR) to figure out how often the two disease occur together.

In the study population, they found, over a five-year period, 763 patients diagnosed with celiac disease, and 1106 diagnosed with microscopic colitis.

In the general population, the standard rates of celiac disease ran from 10.4 to 15.7 per 100,000 people, while the standard rates of microscopic colitis ran from 16.9 to 26.2 per 100,000 people.

The study team found 40 patients with both celiac disease and microscopic colitis, 21 of whom were females aged 40–60 years.

In the celiac disease group, microscopic colitis occurred at an annual rate of 11.4 per 1000 cases of celiac disease with an overall SIR of 52.7.

These findings showed a strong association between microscopic colitis and celiac disease. In fact, the diseases occurred together in the study population at rates of about 50-times those expected in the general population.

One prominent finding was that middle-aged women suffered especially high rates of celiac disease together with microscopic colitis.

Therefore, the team recommends that middle-aged women with celiac disease and persistent diarrhea undergo lower endoscopy with biopsies to check for microscopic colitis.

Source:

• Alimentary Pharmacology & Therapeutics. 2011;33(12):1340-1349.

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