Upper Gastrointestinal Motor Abnormalities in Children with Active Celiac Disease

Cucchiara, Salvatore; Bassotti, Gabrio; Castellucci, G; Minella, R.; Betti, Camilla; Fusaro, C; Morelli, Antonio; Bertotto, A; Auricchio, Salvatore

doi:10.1097/00005176-199511000-00011

Cited by 45 publications

(32 citation statements)

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“…Two hypotheses may be formulated: (a) our patients had foodrelated IBS with particularly severe intestinal motor derangement, although they did not ful®ll criteria for IBS but rather those for functional diarrhea, a separate entity (Drossman et al, 1990); (b) intestinal dysmotility is a feature of food intolerance, whose expression may be similar to other`irritative' or`allergic' small bowel reactions related to particular foodstuffs in a given subject. We favour this latter hypothesis, since there is recent evidence of discrete motor abnormalities (resembling those described in the present study) in adults (Bassotti et al, 1994) and children (Cucchiara et al, 1995) with active celiac sprue, a well de®ned food allergy disease. Moreover, evidence is increasingly mounting that food-related mucosal reactions may in¯uence small bowel motor activity through several mechanisms, including the release of numerous substances acting on gastrointestinal motility, such as histamine, 5-HT, prostaglandins, etc.…”

Section: Considerationssupporting

confidence: 82%

Heretical thoughts about food hypersensitivity: small bowel manometry as an objective way to document gut reactions

1997

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Background: Food hypersensitivity is a frequent complaint by both pediatric and adult subjects. However, notwithstanding patient' belief about`allergies' related to food stuffs, only a minority of them have actually such a diagnosis substantiated. Moreover, the diagnostic approach to these problems is cumbersome and unsatisfactory, and the objectivation of a food hypersensitivity is often dif®cult. Patients and methods: For these reasons we studied by means of small bowel manometry a small group of patients with food hypersensitivity, and showed abnormal fasting and postprandial ®ndings in those with the gut as a target organ on clinical grounds. Results: Manometric abnormalities were somewhat similar to those previously described in celiac disease, a well recognized food allergy disease. The possible usefulness of this technique in the investigative approach of food hypersensitivity is discussed.

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Section: Considerationssupporting

confidence: 82%

Heretical thoughts about food hypersensitivity: small bowel manometry as an objective way to document gut reactions

1997

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“…In situ endomysial antibody deposition would also be a reasonable case for the gastrointestinal motility disorder observed in other clinical studies. 38 Direct evaluation of the effect and dynamics of extraintestinal TG2 antibody deposition is especially difficult as repeated biopsies were not possible in our cases. In addition, our liver patients also had independent hepatic diseases (case 4: cystic fibrosis, parvovirus B19 infection 39 ; case 5: hepatitis B infection).…”

Section: Discussionmentioning

confidence: 89%

In vivo targeting of intestinal and extraintestinal transglutaminase 2 by coeliac autoantibodies

Korponay-Szabó

Halttunen

Szalai

et al. 2004

Gut

306

287

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“…CD patients displayed a shorter length of phase III of MMC as well as postprandial contractility in children with CD [30]. The same group performed a study in 11 untreated and 12 treated adult CD patients and demonstrated that more than 80% of untreated celiacs had discrete motor abnormalities of the upper gut, in both fasting and fed periods [31].…”

Section: Gastrointestinal Motility Alterations In CD and Ncgsmentioning

confidence: 99%

Motility Alterations in Celiac Disease and Non-Celiac Gluten Sensitivity

Sánchez

Berčík²,

Verdú³

2015

Dig Dis

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Regulation of gut motility is complex and involves neuromuscular, immune and environmental mechanisms. It is well established that patients with celiac disease (CD) often display gut dysmotility. Studies have shown the presence of disturbed esophageal motility, altered gastric emptying, and dysmotility of the small intestine, gallbladder and colon in untreated CD. Most of these motor abnormalities resolve after a strict gluten-free diet, suggesting that mechanisms related to the inflammatory condition and disease process are responsible for the motor dysfunction. Motility abnormalities are also a hallmark of functional bowel disorders such as irritable bowel syndrome (IBS), where it has been proposed as underlying mechanism for symptom generation (diarrhea, constipation, bloating). Non-celiac gluten sensitivity (NCGS) is a poorly defined entity, mostly self-diagnosed, that presents clinically with IBS symptoms in the absence of specific celiac markers. Patients with NCGS are believed to react symptomatically to wheat components, and some studies have proposed the presence of low-grade inflammation in these patients. There is little information regarding the functional characterization of these patients before and after a gluten-free diet. A study suggested the presence of altered gastrointestinal transit in NCGS patients who also have a high prevalence of nonspecific anti-gliadin antibodies. Results of an ongoing clinical study in NCGS patients with positive anti-gliadin antibodies before and after a gluten-free diet will be discussed. Elucidating the mechanisms for symptom generation in NCGS patients is important to find new therapeutic alternatives to the burden of imposing a strict gluten-free diet in patients who do not have CD.

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Upper Gastrointestinal Motor Abnormalities in Children with Active Celiac Disease

Cited by 45 publications

References 0 publications

Heretical thoughts about food hypersensitivity: small bowel manometry as an objective way to document gut reactions

Heretical thoughts about food hypersensitivity: small bowel manometry as an objective way to document gut reactions

In vivo targeting of intestinal and extraintestinal transglutaminase 2 by coeliac autoantibodies

Motility Alterations in Celiac Disease and Non-Celiac Gluten Sensitivity

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