Higher Risk of Functional Constipation and IBS in Celiac Children on Gluten-Free Diet

Celiac.com 10/19/2020 - A team of researchers recently set out to determine the rates of functional abdominal pain disorders (FAPDs) and functional constipation in children with celiac disease on a strict gluten free diet.

The research team included Fernanda Cristofori, MD; Mariaelena Tripaldi, MD; Giusi Lorusso, MD; Flavia Indrio, MD; Vincenzo Rutigliano, MD PhD; Domenico Piscitelli, MD; Stefania Castellaneta, MD; Vincenzo Bentivoglio, MD; and Ruggiero Francavilla, MD, PhD. 

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They are variously affiliated with the Interdisciplinary Department of Medicine-Paediatric Section, University of Bari, Italy; the Department of Paediatrics San Paolo Hospital, Bari, Italy; Section of Pathology, Department of Emergency and Organ Transplantation, University of Bari, Italy; the San Giacomo Hospital, Monopoli (BA), Italy; the  Faculty of Medicine, Paediatrics Specialization School University of Padua; and the “B. Trambusti” Department Giovanni XXIII Hospital- Via Amendola 207 Bari, Italy.

For their prospective study, the team looked at 154 males and 263 women at a tertiary care center in Italy from 2016 through 2018. All patients were diagnosed with celiac disease according to ESPGHAN criteria, followed a strict gluten-free diet for more than 1 year, and also had negative results from serologic tests.

Patients with celiac disease had higher rates of FAPDs, at 11.5%, compared to 6.7% for control subjects, while the relative risk was nearly 2%. Nearly 20% of celiac patients had functional constipation (functional constipation), and more than 7% had irritable bowel syndrome (IBS), defined by the Rome IV criteria, compared with more than 10% and 3.2% respectively for control subjects.

Parents and children over 10 years old answered questions about pediatric gastrointestinal symptoms, according Rome IV criteria. 

As a control group, the team used 145 male and 227 female siblings or cousins, who had negative results from serologic test for celiac disease.

People with celiac disease face an increased risk of both IBS and functional constipation. The team stresses the importance of strategies for managing IBS and functional constipation in celiac patients.

Read more in CGHjournal.com