Upper gastrointestinal motor abnormalities in children with active celiac disease

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.