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Upper gastrointestinal motor abnormalities in children with active celiac disease
S Cucchiara1, G Bassotti, G Castellucci
1Dipartimento di Pediatria, Università degli Studi di Napoli, Italy.
Insights
Celiac disease in children often causes gastrointestinal (GI) motor abnormalities, impacting gut motility. A gluten-free diet can reverse these motor dysfunctions, improving gut function.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Motility Disorders
- Celiac Disease Pathophysiology
Background:
- Clinical suspicion of gastrointestinal (GI) motor disorders in celiac disease lacks objective evidence.
- Celiac disease is an autoimmune disorder triggered by gluten ingestion, affecting the small intestine.
Purpose of the Study:
- To investigate and identify potential GI motor abnormalities in children with active celiac disease.
- To assess the impact of a gluten-free diet on GI motor function in pediatric celiac disease.
Main Methods:
- Gastroduodenojejunal manometric recordings were performed in 14 children with active celiac disease (age 1-13 years) during fasting and fed states.
- Four patients were reassessed after a 6-month gluten-free diet, and data were compared to 8 healthy controls.
Main Results:
- Children with celiac disease exhibited significantly shorter activity front durations and reduced postprandial antral motility index compared to controls.
- >90% of celiac patients displayed marked fasting and/or fed motor abnormalities, indicative of a potential neuropathic disorder.
- Gut dysmotilities resolved in the four patients after adhering to a gluten-free diet for 6 months.
Conclusions:
- Celiac disease frequently impacts gut motor behavior in children, often presenting as neuropathic-like motor abnormalities.
- Dietary intervention with a gluten-free diet can effectively reverse these GI motor dysfunctions in pediatric celiac disease.
Abstract:
Although from the clinical point of view a GI motor disorder can be suspected in celiac disease, objective evidence for this is still lacking. We therefore conducted a study on children with active celiac disease to detect possible GI motor abnormalities in this disease. Fourteen children (age range, 1-13 years) were studied; they underwent fasting and fed manometric recordings in the gastroduodenojejunal area. Four patients were restudied after a 6-month gluten-free diet. Data were compared with those obtained in eight control children. As compared with controls, celiac disease patients showed a shorter duration of activity fronts (p < 0.01) and a significant (p < 0.01) reduction of the postprandial antral motility index; furthermore, > 90% of the patients displayed marked fasting and/or fed motor abnormalities, suggesting a neuropathic disorder. Interestingly, gut dysmotilities disappeared in the four subjects reassessed after the gluten-free diet. It is concluded that celiac disease frequently affects the motor behavior of the gut and that its effects may be reversed by appropriate diet.