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Celiac disease in children with chronic constipation
Murat Çakir1, Seçil Cezaroğlu2, Ümit Çobanoğlu3
1Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Faculty of Medicine, Karadeniz Technical University,Trabzon, Turkey.
Insights
In children with chronic constipation (CC), routine screening for celiac disease (CD) may not be necessary initially. Further evaluation for CD in CC patients should be reserved for those with persistent symptoms or malnutrition.
Area of Science:
- Pediatric Gastroenterology
- Immunology
- Gastrointestinal Disorders
Background:
- Chronic constipation (CC) and celiac disease (CD) are prevalent in pediatric gastroenterology.
- The direct association between CC and CD in children requires further investigation.
Purpose of the Study:
- To determine the prevalence and outcomes of celiac disease (CD) in children experiencing chronic constipation (CC).
Main Methods:
- A cohort of 313 children with CC and 990 healthy controls were assessed.
- Serum IgA and IgA antitissue transglutaminase antibodies (IgA-tTG) were measured.
- Intestinal biopsy and HLA-DQ2/DQ8 typing were performed for elevated IgA-tTG.
Main Results:
- Serology for CD was positive in 2.5% of children with CC versus 0.6% in controls (P < 0.05).
- Two control subjects had total villous atrophy; others showed Marsh 0-1 lesions.
- Potential CD was diagnosed in CC patients and 4 controls; silent CD in 2 controls. Spontaneous loss of tTG-IgA occurred in 75% of potential CD cases within a year.
Conclusions:
- Initial serological screening for celiac disease (CD) may be omitted in children presenting with chronic constipation (CC).
- Consider CD evaluation in CC patients with prolonged symptoms or malnutrition.
Background/Aim:
Chronic constipation (CC) and celiac disease (CD) are the most common conditions encountered in pediatric gastroenterology. The association of these two disorders has not been evaluated properly. We analyzed the prevalence and outcome of CD in children with CC.
Materials And Methods:
The study included children with CC (n = 313) and healthy children (n = 990). Serum IgA and IgA antitissue transglutaminase antibodies (IgA-tTG) were studied in all subjects. Intestinal biopsy and HLA-DQ2/DQ8 typing was performed in subjects with elevated IgA-tTG.
Results:
Serology was positive in 8 children (2.5%) with CC and 6 children (0.6%) from the control group (P < 0.05). Histopathological examination revealed total villous atrophy in two subjects in the control group. Other subjects had Marsh 0-1 lesions. All patients with CC and 4 children from the control group were classified as having potential CD. Two children in the control group had silent CD. Spontaneous loss of serum tTG-IgA occured in 75% of the subjects with potential CD at the end of the 1st year.
Conclusion:
Our study revealed that serological evaluation CD may be omitted in children with CC at initial examination. It may be perform in selected patients such as those associated with prolonged symptoms or malnutrition.
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