Study on Celiac Disease Prevalence in Children with Chronic Diarrhea (+Video)

Celiac.com 06/30/2025 - Celiac disease is often associated with digestive problems like chronic diarrhea, but it can also impact a child's growth and development in ways that aren’t immediately obvious. This study explored how common celiac disease is in children with long-term diarrhea and what factors might help predict who has the condition. Conducted at a hospital in Peshawar, Pakistan, the study sheds light on why doctors should keep celiac disease in mind when evaluating children with digestive issues.

Understanding the Purpose of the Study

The main goal of this research was to find out how frequently celiac disease occurs in children who suffer from chronic diarrhea. Chronic diarrhea—when loose stools continue for several weeks—can have many causes, but celiac disease is one possibility that doctors sometimes overlook. Since untreated celiac disease can lead to serious complications like poor growth, nutrient deficiencies, and even some types of cancer, identifying it early is critical.

How the Study Was Conducted

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The study included 165 children under 14 years of age who were admitted to the hospital with a history of chronic diarrhea. To be included, the children had to have diarrhea lasting for a significant period, but they were excluded if they were already on a gluten-free diet without a formal diagnosis, had bloody diarrhea, or had previously undergone abdominal surgery.

Each child underwent a blood test to detect antibodies associated with celiac disease. Researchers also collected information about each child's age, gender, weight, height, and family history of celiac disease. The children were then grouped based on whether they had normal height and weight for their age and whether they had any relatives with celiac disease.

The analysis compared children who tested positive for celiac disease to those who did not, looking for trends that could point to a higher risk of having the condition.

Key Findings: How Common Is Celiac Disease?

Out of the 165 children in the study, 22 were diagnosed with celiac disease. This means roughly 13 percent of the children with chronic diarrhea had celiac disease—a much higher rate than in the general population. This high percentage shows how important it is to consider celiac disease as a possible diagnosis in children with ongoing diarrhea.

Interestingly, the study found that some expected risk factors, like age, gender, or being underweight, did not strongly predict whether a child had celiac disease. However, two factors—short stature and family history—were more closely associated with the condition.

Short Stature as a Red Flag

One of the most significant findings was the strong link between celiac disease and short stature. Children who were shorter than average for their age were much more likely to have celiac disease than those who were of average height. In fact, nearly 29 percent of children with short stature had celiac disease, compared to just 6 percent of children with normal height.

This suggests that poor growth could be an important sign of undiagnosed celiac disease in children who also have chronic diarrhea. Since malnutrition caused by the condition can impair growth, it makes sense that height might be more telling than weight. The results support the idea that children with unexplained short stature should be evaluated for celiac disease, especially if they also have digestive symptoms.

Family History and Genetic Risk

Another factor that initially appeared to predict celiac disease was family history. Children who had a parent or sibling with celiac disease were more likely to be diagnosed themselves. However, when researchers adjusted for other factors, family history was no longer a strong predictor on its own.

This doesn’t mean family history isn’t important—it still reflects a genetic risk—but it suggests that other signs, like poor growth or digestive symptoms, may be even more useful for spotting potential cases.

Why Weight May Be Less Helpful Than Expected

Being underweight has long been considered a classic sign of celiac disease. But in this study, children with low weight were not significantly more likely to have the condition than those with normal weight. This supports a growing body of research showing that children with celiac disease can appear healthy or even overweight.

For parents and doctors, this finding is important. It means that a child’s weight alone should not rule out or confirm celiac disease. Even children who look well-nourished may be dealing with silent damage to their intestines caused by gluten.

Comparison with Other Countries

The study’s results align with similar research conducted in other parts of the world. In countries like India and Bangladesh, the percentage of children with chronic diarrhea who also have celiac disease ranges from about 12 to 35 percent, depending on how the studies were conducted. This wide range shows that geographic differences, healthcare access, and how chronic diarrhea is defined all affect the reported rates.

Interestingly, children in developed countries like Canada are often diagnosed at a younger age. This is likely due to better awareness among healthcare providers and easier access to diagnostic tests. In contrast, children in less-resourced settings may go undiagnosed for longer, which can lead to more severe symptoms.

Strengths and Limitations of the Study

One strength of this study is its focus on children in a region where celiac disease is likely underdiagnosed. By using a structured approach and including blood tests for diagnosis, the researchers provided valuable insight into how often celiac disease occurs in this specific group.

However, the study also had some limitations. It was conducted at a single hospital and did not use intestinal biopsies—the gold standard for diagnosis. This means some cases might have been missed, or some children might have been misclassified. Also, the relatively small number of children in the study may limit how broadly the findings can be applied.

Why This Study Matters for Children with Celiac Disease

This study highlights an important message: celiac disease should be considered more often in children with chronic diarrhea, especially when accompanied by poor growth. It also shows that relying on weight or family history alone may not be enough to identify children at risk. Instead, a careful evaluation of symptoms and screening tests can help catch celiac disease early and prevent long-term health problems.

For families and healthcare providers, this research reinforces the importance of staying alert to the less obvious signs of celiac disease. When diagnosed early and managed with a strict gluten-free diet, children with celiac disease can recover well, grow normally, and lead healthy lives.

In Summary:

• About 13 out of every 100 children with chronic diarrhea in this study had celiac disease.
• Short stature was a strong indicator of undiagnosed celiac disease.
• Family history and being underweight were less reliable predictors.
• Early screening and diagnosis are crucial to avoid complications.
• Doctors should not rule out celiac disease just because a child seems well-nourished or lacks a family history.

For families of children with digestive issues, this study is a reminder that persistent symptoms deserve thorough evaluation—and that celiac disease may be hiding in plain sight.

Read more at:  cureus.com

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