Is There a Connection Between Celiac Disease and Inflammatory Bowel Disease?

Celiac.com 02/27/2012 - The relationship between celiac disease and inflammatory bowel disease has not been well documented. One study that hasn't gotten too much attention was published in 2008. To get a better idea regarding any connection, a team of researchers studied rates of celiac disease in patients with inflammatory bowel disease, along with the rates of inflammatory bowel disease in patients with celiac disease.

The research team included J.S. Leeds, B.S. Höroldt, R. Sidhu, A.D. Hopper, K. Robinson, B. Toulson, L. Dixon, A.J. Lobo, M.E. McAlindon, D.P. Hurlstone, and D.S. Sanders. They are affiliated with the Gastroenterology and Liver Unit of Royal Hallamshire Hospital in Sheffield, UK. 

The team recruited patients from clinics specializing in inflammatory bowel disease and celiac disease, along with control subjects from the local population. They then tested subjects for Antigliadins, Endomysial, tissue transglutaminase antibodies and total IgA levels. They offered duodenal biopsy to patients with positive antibodies. The team reviewed colonoscopy and biopsy data for celiac patients.

In all, the team assessed 305 patients with celiac disease, 354 patients with IBD, and 601 healthy control subjects. The IBD group included 154 patients with ulcerative colitis (UC), 173 with Crohn's disease, 18 with indeterminate colitis, and nine cases of microscopic colitis. Forty-seven patients showed positive antibodies, while three patients showed villous atrophy upon biopsy.

All three patients with Villous atrophy showed positive anti-tissue transglutaminase antibodies, but only two tested positive for endomysial antibody (EMA). Ten celiac patients had IBD (5 UC and 5 lymphocytic colitis). Five control subjects had celiac disease, while two had IBD (1 Crohn's disease and 1 UC). Stepwise multiple logistic regression showed that only antibody positivity was a factor (p<0.0001).

The results showed that people with celiac disease had IBD at rates ten times higher than the control group (odds ratio 9.98, 95% CI 2.8-45.9, p=0.0006), while patients with IBD had celiac disease at about the same rates control subjects (odds ratio 1.02, 95% CI, 0.24-4.29, p=1.0).

Source:

• Scand J Gastroenterol. 2008;43(10):1279-80

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