Between 10 and 15 percent of school-aged children are affected by recurrent abdominal pain, defined as at least three episodes in three months. A study conducted at the University of Bari, Italy, has revealed a growing population of children with irritable bowel syndrome (IBS) also run the risk of developing celiac disease.
"The identification of IBS as a high-risk condition for celiac disease might be of help in pediatric primary care because it might have become routine to test for celiac disease indiscriminately in all children with recurrent abdominal pain, although our finding suggests that the screening should be extended only to those with IBS,” author of the study Dr. Fernanda Cristofori said in a statement. “This new approach might have important implications for the cost of care because it has been estimated that in children with FGIDs, screening tests are common, costs are substantial, and the yield is minimal.”
According to the U.S. Department of Health and Human Services, celiac disease is a disorder of the digestive system that affects the small intestine and prevents the body from absorbing essential nutrients in food. People with celiac disease are unable to tolerate gluten, a protein found in wheat, rye, and barley. Over two million people in the United States are affected by celiac disease. Irritable bowel syndrome is a functional gastrointestinal (GI) disorder caused by changes in how the GI tract works. IBS is not a disease, but a group of symptoms that occur together.
Cristofori and his colleagues from the university included 782 children with abdominal pain-related disorders, including 270 with IBS, 201 with functional dyspepsia, and 311 with functional abdominal pain. The research team performed blood tests on each patient to discover how many children with a gastrointestinal disorder were also affected by celiac disease. Twelve patients with IBS, two patients with functional dyspepsia, and one patient with functional abdominal pain had also developed celiac disease. Children with IBS were four times more likely to develop celiac disease compared to those affected by other abdominal pain disorders.
"Based on the study by Cristofori et al, we suggest that selective screening for celiac disease is warranted for children with IBS but not for children with other FGIDS (functional gastrointestinal disorders),” Dr. James E. Squires from Cincinnati Children’s Hospital Medical Center said in an accompanying editorial. “However, the lines distinguishing IBS from alternative FGIDS are often blurred. It is within this reality that pediatric health care providers should examine the evidence, evaluate the patient and family, weigh the likelihood of a false positive test result, and make the decision that they believe will benefit the patient most."
Source: Cristofori F, et al. JAMA Pediatrics. 2014.