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    Patients with Active Celiac Disease At Slightly Higher Risk for Eosinophilic Esophagitis


    Jefferson Adams

    Celiac.com 09/09/2015 - Some researchers and clinicians suspect a connection between eosinophilic esophagitis (EoE) and celiac disease, but prior studies have shown conflicting results


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    Image: Wikimedia Commons--Ed Uthman, MD.A team of researchers recently set out to determine the relationship between EoE and celiac disease among patients with concomitant esophageal and duodenal biopsies. The research team included Elizabeth T. Jensena, Swathi Eluria, Benjamin Lebwohl, Robert M. Gentab, and Evan S. Dellon.

    For their cross-sectional study, they team used data covering the period from January 2009 through June 2012 from a U.S. national pathology database.

    They defined esophageal eosinophilia as the presence of ≥15 eosinophils per high-power field. The crude and age and sex adjusted odds of esophageal eosinophilia for patients with active celiac disease were compared with those without celiac disease.

    Sensitivity analyses were performed by using more stringent case definitions and by estimating the associations between celiac disease and reflux esophagitis and celiac disease and Barrett’s esophagus.

    Out of 292,621 patients in the source population, the team looked at data from 88,517 patients with both esophageal and duodenal biopsies. Four thousand one hundred one (4.6%) met criteria for EoE, and 1203 (1.4%) met criteria for celiac disease. Patients with celiac disease had 26% higher odds of EoE than patients without celiac disease (adjusted odds ratio, 1.26; 95% confidence interval [CI], 0.98–1.60).

    The strength of the connection varied according to EoE case definition, but all definitions showed a weak positive association between the two conditions.

    Interestingly, this study showed no connection between celiac disease and reflux esophagitis (adjusted odds ratio 0.95; 95% CI, 0.85–1.07) or between celiac disease and Barrett’s esophagus (adjusted odds ratio 0.89; 95% CI, 0.69–1.14).

    Overall, this study showed only a weak increase in EoE in patients with celiac disease. The connection strengthened in direct relation to the strength of definitions of EoE, and was not seen with other esophageal conditions.

    Doctors should consider concomitant EoE in patients with celiac disease where clinical indications support it.

    Disclosures: Dellon reports receiving research funds from Meritage Pharma, consulting for Aptalis, Novartis, Receptos and Regeneron, and receiving an educational grant from Diagnovus.

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  • About Me

    Jefferson Adams is a freelance writer living in San Francisco. He has covered Health News for Examiner.com, and provided health and medical content for Sharecare.com. His work has appeared in Antioch Review, Blue Mesa Review, CALIBAN, Hayden's Ferry Review, Huffington Post, the Mississippi Review, and Slate, among others.

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    Jefferson Adams
    Celiac.com 10/12/2012 - What is the relationship between breastfeeding, the age of gluten introduction and rates of celiac disease?
    A number of studies have shown that increased breastfeeding may provide some protection against celiac disease. However, one study found no change in the overall prevalence of celiac disease in breastfed infants compared to controls, suggesting that breastfeeding may only delay the presentation of the disease but, does not prevent it. Other studies show no significant difference in the prevalence of celiac disease between breastfed and non-breastfed patients.
    Data from the Swedish celiac disease epidemic suggest a 3% prevalence of celiac disease in the children born during the epidemic. An analysis by Ivarsson et al. of children born during the epidemic, found that children under 2 years of age had a lower risk of celiac disease if they were still being breastfed when dietary gluten was introduced (odds ratio 0.59, 95, with a confidence interval 0.42–0.83). Children who continued breastfeeding after gluten was introduced to their diet showed a further decrease in the risk for celiac disease (OR 0.36, 95% CI 0.26–0.51).
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    A later study, by Akobeng and others, estimated that breastfeeding all babies in the UK at the time of gluten introduction, would prevent 2500 cases of celiac disease every year.
    The best data currently available on celiac disease and the age of gluten introduction comes from a prospective study by Norris et al. The study followed 1560 children in Denver between 1994 and 2004. This study showed that children exposed to gluten in the first 3 months of life had a fivefold increased risk of having celiac disease than children exposed to gluten between 4 and 6 months of age, while children exposed to gluten at 7 months old or later had an almost twofold increased risk compared with those exposed at 4 to 6 months (hazard ratio 1.87, 95% CI 0.97–3.60).
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    The full data won't be available until all children reach the age of 3 years of age, but the researchers hope that the study will offer definitive answers on the relationship between breastfeeding and the age of gluten introduction and rates of celiac disease.
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    This information was compiled by researcher R. Shamir of the Institute for Pediatric Gastroenterology, Nutrition and Liver Diseases, at the Schneider Children's Medical Center of Israel, Petah Tikva, affiliated with Sackler Faculty of Medicine, Tel Aviv University in Ramat Aviv, Israel.
    Source:
    Isr Med Assoc J. 2012 Jan;14(1):50-2.

    Jefferson Adams
    Celiac.com 07/27/2015 - First-degree relatives of individuals with celiac disease are at increased risk for this disorder, but little is known about their risk for other autoimmune diseases.
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    Source:
     Clinical Gastroenterology and Hepatology. DOI: http://dx.doi.org/10.1016/j.cgh.2015.01.026

    Jefferson Adams
    Celiac.com 08/17/2015 - In an interesting update, researcher Giuseppe Mazzarella, of the Immuno-Morphology Lab at the Institute of Food Sciences of the National Council Research in Avellino, Italy recently set out to examine the role of effector and suppressor T cells in celiac.
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    Source:
    World J Gastroenterol. 2015 Jun 28;21(24):7349-56. doi: 10.3748/wjg.v21.i24.7349.

    Jefferson Adams
    Celiac.com 08/19/2015 - For the first time since it was described and named by 1st century Greek physician Aretaeus of Cappadocia, first linked to wheat in the 1940's, and specifically linked to gluten in 1952, scientists have discovered the cause of celiac disease.
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    Source:
    Med.uio.no

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    Christina Kantzavelos
    Celiac.com 07/20/2018 - During my Vipassana retreat, I wasn’t left with much to eat during breakfast, at least in terms of gluten free options. Even with gluten free bread, the toasters weren’t separated to prevent cross contamination. All of my other options were full of sugar (cereals, fruits), which I try to avoid, especially for breakfast. I had to come up with something that did not have sugar, was tasty, salty, and gave me some form of protein. After about four days of mixing and matching, I was finally able to come up with the strangest concoction, that may not look the prettiest, but sure tastes delicious. Actually, if you squint your eyes just enough, it tastes like buttery popcorn. I now can’t stop eating it as a snack at home, and would like to share it with others who are looking for a yummy nutritious snack. 
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    Jefferson Adams
    Celiac.com 07/19/2018 - Maintaining a gluten-free diet can be an on-going challenge, especially when you factor in all the hidden or obscure gluten that can trip you up. In many cases, foods that are naturally gluten-free end up contain added gluten. Sometimes this can slip by us, and that when the suffering begins. To avoid suffering needlessly, be sure to keep a sharp eye on labels, and beware of added or hidden gluten, even in food labeled gluten-free.  Use Celiac.com's SAFE Gluten-Free Food List and UNSAFE Gluten-free Food List as a guide.
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    Jefferson Adams
    Celiac.com 07/18/2018 - Despite many studies on immune development in children, there still isn’t much good data on how a mother’s diet during pregnancy and infancy influences a child’s immune development.  A team of researchers recently set out to assess whether changes in maternal or infant diet might influence the risk of allergies or autoimmune disease.
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    The team found less evidence, and low GRADE certainty, for claims that breastfeeding reduces eczema risk during infancy, that longer exclusive breastfeeding is associated with reduced type 1 diabetes mellitus, and that probiotics reduce risk of infants developing allergies to cow’s milk. 
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    Stay tuned for more on diet during pregnancy and its role in celiac disease.
    Source:
    PLoS Med. 2018 Feb; 15(2): e1002507. doi:  10.1371/journal.pmed.1002507

    Jefferson Adams
    Celiac.com 07/17/2018 - What can fat soluble vitamin levels in newly diagnosed children tell us about celiac disease? A team of researchers recently assessed fat soluble vitamin levels in children diagnosed with newly celiac disease to determine whether vitamin levels needed to be assessed routinely in these patients during diagnosis.
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    Source:
    BMC Pediatrics

    Jefferson Adams
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    Read more at azcentral.com.