June 01, 2020
A new research review provides stronger evidence that inflammatory bowel disease and celiac disease may be linked.
People with celiac disease are nine times more likely to be diagnosed with inflammatory bowel disease than people without the autoimmune disease. On the flip side, inflammatory bowel disease patients are nearly four times more likely to develop celiac disease.
Researchers from McMaster University in Ontario, Canada made those findings after analyzing dozens of studies published between 1978 and 2019 in Europe, North America and Asia.
Previous studies also had observed a possible link between the two diseases, but the association continues to be controversial. Because some studies have produced contradictory results, not all experts believe additional screenings are warranted.
Celiac disease is an autoimmune disorder in which the ingestion of gluten causes a person's immune system to attack the small intestine. That damages the villi lining in the small intestine, which affects nutrient absorption.
Inflammatory bowel disease, which includes Crohn's disease and ulcerative colitis, is caused by the inflammation of the gastrointestinal tract.
"Clinicians have always suspected that IBD and celiac disease may be linked, however, a clear association was never established," Dr. Maria Ines Pinto-Sanchez, a gastroenterologist involved in the study, said in a statement.
"This is important, as failure to diagnose one or the other condition could compromise proper response to available treatments. It also raises questions on screening for the other disease in a patient already diagnosed with either IBD or celiac disease."
IBD and celiac disease share similar risk factors. Both involve chronic intestinal inflammation and have possible genetic and environmental contributing factors. Overlapping symptoms include abdominal pain, diarrhea and anemia.
Researchers said the next step is to determine whether testing for the two diseases offers any benefits. More studies are needed to determine whether screening and therapeutic interventions would improve patient outcomes.
"At this time, it is unclear whether screening of IBD should be performed in celiac disease and vice versa," study co-author Dr. Elena Verda said.
The review was published in the journal Gastroenterology.