Dietary Gluten Intake Does Not Increase Risk of Microscopic Colitis Among US Women Without Celiac Disease

Celiac.com 09/27/2018 - Microscopic colitis is a frequent culprit in cases of chronic watery diarrhea among elderly patients. Although patients with microscopic colitis seem to have higher rates of celiac disease, researchers haven’t done much research on the relationship between dietary gluten consumption, and risk of microscopic colitis in people who do not have celiac disease.

A team of researchers recently prepared a prospective study of US women without celiac disease. The research team included Po-Hong Liu MD, MPH; Benjamin Lebwohl MD, MS; Kristin E. Burke MD; Kerry L. Ivey PhD; Ashwin N. Ananthakrishnan MBBS, MPH; Paul Lochhead MBChB, PhD; Ola Olen MD, PhD; Jonas F. Ludvigsson MD, PhD; James M. Richter MD; Andrew T. Chan MD, MPH; & Hamed Khalili MD, MPH. 

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The research team studied 160,744 US women without celiac disease who were enrolled in the Nurses’ Health Study (NHS) and the NHSII. They then estimated dietary gluten intake using validated food frequency questionnaires at four year intervals. They confirmed cases of microscopic colitis through a review of medical records. The team used Cox proportional hazard modeling to estimate the multivariable-adjusted hazard ratio (HR) and 95% confidence interval (CI).

The researchers found 219 cases of microscopic colitis over more than 20 years of follow-up covering 3,716,718 person-years, for a crude incidence rate of 5.9 cases per 100,000 person-years, in NHS and NHSII. 

Most significantly, they found that dietary gluten intake did not influence the risk of developing microscopic colitis. Compared to individuals in the lowest quintile of energy-adjusted gluten intake, the adjusted HR of microscopic colitis was 1.18 for the middle quintile and 1.03 for the highest quintile. 

Even adjusting the figures to account for primary gluten sources, including refined and whole grains, made no substantial difference in the effect estimates. Further, there was no difference in association rates according to lymphocytic or collagenous subtypes; nor were the rates changed by age, smoking status, or body mass index.

The good news from this study is that gluten intake plays no role in promoting microscopic colitis in adult women without celiac disease.

Read more at: The American Journal of Gastroenterology (2018)