Is celiac disease misdiagnosed in children with functional constipation?


eMediNexus    31 May 2018

The purpose of a new study published in the Turkish Journal of Gastroenterology was to determine the prevalence of celiac disease (CD) in patients with chronic constipation. The present study recruited 1,046 children, 2-18 years old, diagnosed with chronic constipation according to the Rome III criteria. In these patients, serum immunoglobulin A, tissue transglutaminase, and/or anti-endomysial antibodies were examined. The patients with serological positive results were subjected to upper gastrointestinal system endoscopy and duodenal biopsy to confirm the diagnosis of CD. The findings revealed that blood tests were positive in 3.25% of these patients. One patient had Hashimotos thyroiditis, and four patients had short stature. Endoscopic findings included nodularity in bulbous and duodenal mucosa in 16; scalloping fold in 13; and normal mucosa in five patients. While histopathologic exhibited that 10 patients had total villous atrophy, 24 had subtotal and partial villous atrophy, and 34 had intraepithelial lymphocyte infiltration. All patients followed a gluten-free diet, resulting in a resolution of symptoms. Hence, a CD ratio of 1:28 was diagnosed in chronically constipated children. Therefore, it was suggested that screening tests for CD should be considered in children with conventional treatment-resistant constipation.

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