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Prevalence and Predictors of Celiac Disease in Children With Constipation
Monika Meena1, Manish Narang1, Rajesh Kumar Meena2
1Department of Pediatrics, University College of Medical Sciences (University of Delhi) and Associated Guru Teg Bahadur Hospital, Delhi, India.
Insights
Constipation in children is linked to a higher prevalence of celiac disease, particularly when accompanied by growth failure. Early screening for celiac disease is crucial in these cases.
Area of Science:
- Pediatric Gastroenterology
- Autoimmune Diseases
- Nutritional Deficiencies
Background:
- Constipation is a common pediatric complaint.
- Celiac disease is an autoimmune disorder triggered by gluten.
- The association between constipation and celiac disease in children requires further investigation.
Purpose of the Study:
- To determine the prevalence of celiac disease in children experiencing constipation.
- To identify predictors of celiac disease among constipated children.
- To compare celiac disease prevalence in constipated versus non-constipated children.
Main Methods:
- A hospital-based cross-sectional study involved 460 children aged 1-12 years.
- Children were categorized into constipated (cases) and non-constipated (comparison) groups based on ROME IV criteria.
- Screening for celiac disease included serum anti-tissue transglutaminase IgA (tTG-IgA) and, when positive, upper gastrointestinal endoscopy with duodenal biopsy.
Main Results:
- The overall prevalence of biopsy-confirmed celiac disease was 3.26% (15/460).
- Children with constipation showed a significantly higher prevalence of celiac disease (5.65%) compared to controls (0.87%, P = 0.004).
- Wasting and stunting were significantly associated with celiac disease in constipated children (P < 0.001).
Conclusions:
- Constipation in children is associated with a substantially higher prevalence of celiac disease.
- Growth failure (wasting and stunting) are significant indicators of celiac disease in constipated children.
- This highlights the importance of screening for celiac disease in constipated children, especially those with impaired growth.
Objective:
To determine the prevalence of celiac disease and its predictors in children with constipation.
Methods:
A hospital-based cross-sectional comparative study was conducted between November, 2018 to April, 2020. Children aged 1-12 years were screened for the presence of constipation as per ROME IV criteria and designated as cases. Age and sex matched healthy children with normal bowel habits were enrolled as comparison group. Participants underwent a detailed history and examination, and were screened for celiac disease by estimating serum anti-tissue transglutaminase IgA antibody levels (tTG-IgA). Upper gastrointestinal endoscopy and duodenal biopsy were performed in all participants who tested positive on screening (serum tTG-IgA ≥ 20 U/mL). The prevalence of celiac disease and associated factors were compared between the two groups.
Results:
A total of 460 children (230 in each group) with mean (SD) age 64.08 (37.12) months were enrolled. Twenty-one (4.6%) children screened positive for anti tTG antibodies, among these 15 (75%) children had biopsy features suggestive of celiac disease (Marsh grade III). Children with constipation had significantly higher prevalence of celiac disease (5.65% vs 0.87%, P = 0.004) compared to children without constipation. Wasting and stunting were significantly associated with celiac disease in constipated children (P < 0.001).
Conclusion:
Children with constipation and associated growth failure have a high prevalence of celiac disease.
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