Celiac: It's in the Intestines

Celiac disease in children may be linked with intestinal folding problems

February 12, 2013 / Author:  / Reviewed by: Robert Carlson, M.D

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(dailyRx News) Just because children may eat their vegetables doesn't mean they're always healthy. If kids have celiac disease, they may not be properly digesting their nutrients. And how their intestines stretch out may help tell whether the disease is to blame.

Though rare, parts of the intestine can slip back into other parts of the intestine. This problem is more common among children with untreated celiac disease than other young patients, according to a recently published study.

However, the findings show that diagnosing celiac disease should be considered in all children, regardless of how healthy they look or feel.

"Talk to your doctor if you lose weight unexpectedly."

When the intestines fold back on themselves, it is called intussusception. It is the second most common cause of blockages along the gastrointestinal tracts of children, who have the problem more often than adults.

Intussusception has not yet been linked with celiac diseases, in which the lining of the small intestine is damaged and nutrients cannot be absorbed properly.

Researchers, led by Norelle Reilly, MD, pediatric gastroenterologist in the Division of Pediatric Gastroenterology at Columbia University Medical Center, aimed to see how many children with intussusception have celiac disease.

The study included 254 children with celiac disease who also had intussusception. The children were treated at Columbia University Medical Center between 2000 and 2010 and had tissue samples taken from their colons to diagnose their celiac disease. Researchers also looked at each child's radiology record.

More than 20 percent of the children had abdominal pain and had images taken of their abdomen.

Researchers found that among the children with celiac disease, 1.2 percent had intussusception less than nine months before being diagnosed with celiac disease. Of all the children seen at the medical center, less than 1 percent had intussusception.

Most of the children with both celiac disease and intussusception were not nutrient deficient.

Researchers were not sure whether intussusception was the cause for chronic or recurrent abdominal pain in children with celiac disease or for chronic abdominal pain in general.

"Abdominal pain is a frequently presenting complaint in children diagnosed as having celiac disease, although the etiology of the pain is unclear," researchers wrote in their report.

At the same time, children with celiac disease who had been given a gluten-free diet as treatment did not have intussusception.

Researchers reported that all of the patients who had intussusception and were later diagnosed with celiac disease grew normally. The results point to the need to examine children who still look healthy.

"Celiac disease may be an underlying cause of intussusception and should be considered even in well-appearing children, although particularly if nutritional deficiencies or growth failure are also seen or in the setting of baseline abdominal complaints," researchers wrote.

The researchers noted that not all the patients had complete radiology records. The results may not be generalized to other patients with celiac disease since the participants in the study came from one institution.

The study was published in the January issue of the Journal of Pediatric Gastroenterology & Nutrition. Funding information was not available.