Celiac disease prevalence is not increased in patients with functional dyspepsia

Abstract

-Background -Previous evidence trying to assess the risk of celiac disease among dyspeptic patients has been inconclusive, showing in some cases notorious discrepancies. Objective -To determine the prevalence of celiac disease in patients with dyspepsia compared to healthy controls without dyspepsia. Methods -Adult patients under evaluation for dyspepsia were invited to participate. These patients were offered an upper gastrointestinal endoscopy with duodenal biopsies. On the other hand, asymptomatic adult volunteers who performed a preventive visit to their primary care physician were invited to participate and agreed to undertake an upper gastrointestinal endoscopy with duodenal biopsies as well. Those patients with histologic signs of villous atrophy were furtherly evaluated and serological tests were performed in order to determine celiac disease diagnosis. Celiac disease prevalence was compared between groups. Results -Overall, 320 patients with dyspepsia and 320 healthy controls were recruited. There were no significant differences in terms of gender or age between groups. Celiac disease diagnosis was made in 1.25% (4/320) of patients in the dyspepsia group versus 0.62% (2/320) in the control group. Conclusion -Patients with dyspepsia who underwent routine duodenal biopsies did not show an increased risk for celiac disease when compared to healthy individuals. HEADINGS -Celiac disease. Dyspepsia. Endoscopy.

Routine Multiple Duodenal Biopsy during Endoscopy of Dyspeptic Patients Seems Unnecessary for Screening of Celiac Disease

“…Our findings are also slightly higher than the reported prevalence for CD among dyspeptic patients [14][15][16][17][18]. Lasa et al compared 320 dyspeptic patients with 320 healthy individuals in Argentina and found the prevalence of CD to be 1.25% in patients with dyspepsia and 0.62% in healthy controls [26]. The inconsistencies between our results and those mentioned can be attributed to different patient characteristics as well as different diagnostic criteria for detecting dyspepsia and CD.…”

“…Nevertheless, Lecleire et al state that endoscopic markers of villous atrophy are not able to identify a subgroup of patients who would benefit from duodenal biopsy [28]. Contrary to previous statements, Lasa et al stated that screening in dyspeptic patients cannot be recommended due to comparable prevalence of CD in healthy individuals and dyspeptic patients [26].…”

The Role of Gluten in Gastrointestinal Disorders: A Review

“…Functional symptoms and, in particular, functional dyspepsia are, in fact, frequently reported by Celiac patients; therefore, we firstly described paper evaluating the risk of developing CD in patients with functional dyspepsia (FD) and vice versa, as well as the prevalence of FD in CD patients [ 68 , 69 ]. As described by Lasa et al in their case-control study of 320 patients with FD, CD was diagnosed in 1.25% of the dyspeptic patients versus 0.62% of the controls [ 69 ] concluding that there was not an increased risk of CD for patients with functional dyspepsia when compared to healthy individuals [ 69 ]. Santolaria et al instead suggested that CD could be more prevalent in patients with FD [ 70 ].…”

The Role of Diet in Functional Dyspepsia Management

“…Functional symptoms, irritable bowel syndrome (IBS), and dyspepsia are frequent occurrences in patients with celiac disease, with an OR of 4.48 for biopsyproven celiac disease in patients fulfilling the Rome criteria for IBS (95% CI: 2.33-8.60) (22). However, the risk of celiac disease in patients with functional dyspepsia does not seem to be increased (23). Conversely, during an observational study in a cohort of 85 patients with diagnosed celiac disease, 27% of the patients fulfilled the criteria of functional dyspepsia upon inclusion, and only 8% of the patients remained dyspeptic after consuming a gluten-free diet for 1 year (24).…”