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Celiac disease and recurrent pancreatitis
R S Patel1, F C Johlin, J A Murray
1Department of Gastroenterology and Hepatology, University of Iowa College of Medicine, Iowa City, Iowa, USA.
Gastrointestinal Endoscopy
|November 26, 1999
Summary
Celiac disease is linked to pancreatico-biliary issues like papillary stenosis and pancreatitis. Early diagnosis and treatment, including a gluten-free diet, can improve outcomes for these patients.
Area of Science:
- Gastroenterology
- Immunology
Background:
- Celiac disease is linked to pancreatico-biliary conditions.
- Potential mechanisms include impaired gallbladder emptying and pancreatitis from malnutrition.
- Duodenal inflammation and papillary stenosis may also connect celiac disease to pancreatico-biliary abnormalities.
Purpose of the Study:
- To investigate the association between celiac disease and pancreatico-biliary abnormalities.
- To determine if celiac disease contributes to papillary stenosis or idiopathic recurrent pancreatitis.
Main Methods:
- 169 patients with suspected sphincter of Oddi dysfunction underwent pancreatico-biliary manometry.
- Patients were tested for gliadin and endomysial antibodies.
- Biopsies of the duodenum and papilla were performed in antibody-positive patients.
Main Results:
- Celiac disease was diagnosed in 12 patients (7.1%), with a mean age of 61.
- All celiac patients presented with recurrent abdominal pain or idiopathic pancreatitis.
- Histologic findings revealed periampullary inflammation and celiac disease changes; 10 patients underwent sphincterotomy.
Conclusions:
- A novel association between celiac disease and papillary stenosis is described in 12 patients.
- Celiac disease was newly diagnosed in 9 of these patients.
- Celiac disease should be considered in the differential diagnosis of papillary stenosis and idiopathic recurrent pancreatitis.