The prevalence of celiac disease is four times higher among children who have irritable bowel syndrome than in the general population of children, according to a report published online April 21 in JAMA Pediatrics.
Celiac disease was recently shown to occur approximately four times more often in adults with IBS than in the general population, but the prevalence in the pediatric population has not been assessed.
Researchers in Italy performed a prospective observational cohort study involving all 992 children aged 4-16 years who were referred to a single university hospital for recurrent abdominal pain during a 6-year period. About 43% of the children were boys. The median age was 6.8 years.
A total of 270 children were found to have irritable bowel syndrome. Fifteen of them also tested positive for serum IgA antitissue transglutaminase and endomysial antibodies, and all 15 also proved to have mucosal atrophy on duodenal biopsy specimens, which is indicative of celiac disease, said Dr. Fernanda Cristofori of the University of Bari (Italy) and Giovanni XXIII Hospital.
Thus, the prevalence of celiac disease was 4.4% in the children who had IBS. In comparison, the highest prevalence of celiac disease in any Italian population of children assessed to date was 1.1% in a study of 3,188 school children, the investigators said (JAMA Ped. 2014 April 21 [doi:10.1001/jamapediatrics.2013.4984]).
Clinicians should consider screening their IBS patients for celiac disease, given that 1 in 23 children with IBS in this series proved to have concomitant celiac disease. Failing to diagnose celiac disease in childhood increases the risk of complications such as osteopenia, short stature, delayed puberty, infertility, and intestinal lymphoma in late adulthood, Dr. Cristofori and her associates noted.
They reported no financial conflicts of interest.