Related Experiment Video
Updated: Mar 24, 2026
3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Risk of Headache-Related Healthcare Visits in Patients With Celiac Disease: A Population-Based Observational Study
Benjamin Lebwohl1,2,3, Abhik Roy, Armin Alaedini1
1Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Insights
Patients with celiac disease (CD) have a significantly higher risk of headache-related healthcare visits. This increased risk also extends to individuals with intestinal inflammation or positive CD serology, even without villous atrophy.
Area of Science:
- Gastroenterology
- Neurology
- Epidemiology
Background:
- Celiac disease (CD) is associated with an increased risk of headaches, but large-scale studies are limited.
- Understanding this association is crucial for patient care and management.
Purpose of the Study:
- To investigate the risk of headache-related healthcare encounters in patients diagnosed with celiac disease.
- To assess the association between CD and subsequent headache visits in a nationwide population-based setting.
Main Methods:
- A retrospective cohort study was conducted using nationwide data from Sweden.
- Patients with celiac disease (identified by villous atrophy) were matched with controls.
- Cox proportional hazards models were used to analyze the association between CD and headache visits.
Main Results:
- The incidence of headache-related visits was significantly higher in CD patients (4.7%) compared to controls (2.9%).
- Patients with CD showed a 1.66-fold increased risk of headache-related visits (HR 1.66; 95% CI 1.56-1.77).
- Increased risk was also observed in individuals with inflammation without villous atrophy (HR 2.08) and those with positive serology but normal histology (HR 1.83).
Conclusions:
- A significantly increased risk of headache-related visits is associated with celiac disease.
- This elevated risk extends to individuals with intestinal inflammation and positive CD serology, irrespective of biopsy findings.
- Headache-related visits are more prevalent in these patient groups, warranting further clinical consideration.
Background And Aims:
Patients with celiac disease (CD) are reported to be at increased risk for headaches, though large studies are lacking. We aimed to examine the risk of headache-related healthcare encounters in patients with CD in a nationwide population-based setting.
Methods:
In this population-based retrospective cohort study, we searched all (n = 28) pathology departments in Sweden and identified patients with CD based on the presence of villous atrophy (VA). Each patient was matched to up to 5 controls, by age, gender, calendar period, and region. Using Cox proportional hazards, we tested for an association between CD and subsequent headache-related visit. We also tested this association for those with intestinal inflammation but normal villi, and subjects with positive CD serologies but normal histology.
Results:
Among 28,638 patients with CD and 143,126 controls, headache-related visit occurred in 1,337 (4.7%) and 4,102 (2.9%), respectively. The incidence of headache-related visit was 423 per 100,000 person-years in CD patients and 254 per 100,000 person-years in controls (HR 1.66; 95% CI 1.56-1.77; P < .0001). Individuals having inflammation without VA on small intestinal biopsy (n = 12,898; HR 2.08; 95% CI 1.90-2.27; P < .0001) and those with normal mucosa but positive CD serology (n = 3,617; HR 1.83; 95% CI 1.57-2.12; P < .0001) were also at increased risk for headache-related visit.
Conclusions:
In this population-based study we found a significantly increased risk of headache-related visits in patients with CD; this increase was also present in patients with intestinal inflammation and those with positive CD serology but with normal mucosal architecture on small bowel biopsy. Though limited by surveillance bias, this study indicates that headache-related visits are more common in these populations.
Related Concept Videos
01:30Other Disorders of Digestive System
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:17Assessment of the Gastrointestinal System I: Subjective Data
Health History
The initial step in assessing the GI system is obtaining a comprehensive health history. This includes inquiring about the patient's history or presence of problems...
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:25Factors Influencing Drug Absorption: Disease States and Pharmacology
Substances such as alcohol and specific drugs, including antineoplastics, can also negatively impact drug absorption. For instance,...
01:29Assessment of the Gastrointestinal System II: Health Perception Pattern
Health Perception Patterns
Health perception patterns offer valuable insights into a patient's lifestyle habits and how they may impact their GI health. These patterns include: