The aim of a recent study published in the Archives of Gastroenterology evaluated the frequency of elevated anti-transglutaminase (anti-tTG) in children with constipation after failure to improve during 6 weeks of appropriate treatment of constipation. This cross sectional study recruited 550 children with prolonged constipation - constipation which fails to resolve after 6 weeks of appropriate treatment. Constipation was defined according to the ROME III criteria. Serum anti-tTG level was measured using ELISA; anti-tTG above 10 was considered positive if IgA was normal. The mean age of the children was 6.8±2.9 years; anti-tTG antibody level was 5.8±2.8 unit/mL. The findings showed that 7.6% of the children had positive anti-tTG antibodies. Meanwhile, celiac disease was confirmed in 40 cases through histopathological examination. Thus, it was noted that anti-tTG was positive in 7.6% of children with chronic constipation who failed to respond after 6 week of treatment.