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Physicians are learning how celiac disease and IBD are linked. Getty Images
  • A new study found a ninefold increased risk of having IBD in patients previously diagnosed with celiac disease.
  • Both celiac and IBD are chronic and tend to begin in early adulthood, but the causes of IBD and celiac disease are still unknown.
  • Experts say this is important because failing to diagnose one or the other condition in patients could compromise proper response to the available treatments.

Researchers have now established a clear connection between inflammatory bowel disease (IBD) and celiac disease.

A recently published study by the Farncombe Family Digestive Health Research Institute at McMaster in collaboration with the Society for the Study of Celiac Disease has found a ninefold increased risk of having IBD in patients previously diagnosed with celiac disease, a serious autoimmune condition triggered by eating foods containing gluten.

“Our systematic review has confirmed that there is a strong association between IBDs and celiac disease,” corresponding study author Dr. Elena Verdu, PhD, professor, division of gastroenterology, department of medicine at McMaster University, told Healthline. “This is important, as failure to diagnose one or the other condition could compromise proper response to available treatments.”

The Centers for Disease Control and Prevention (CDC) estimates about 3 million U.S. adults were diagnosed with IBD in 2015. IBD can include many conditions, but ulcerative colitis and Crohn’s disease are the most common.

The condition is chronic and tends to begin in early adulthood, but the causes of IBD and celiac disease are still unknown.

“Clinicians have always suspected that IBD and celiac disease may be linked, however a clear association was never established,” said first study author Dr. Maria Ines Pinto-Sanchez, associate professor of medicine at McMaster University in a statement.

The McMaster study was a meta-analysis, which means it assessed previous research.

“There have been independent studies that tried to investigate the association between IBDs and celiac disease, with different designs and some inconclusive results,” said Verdu.

She explained this is why her team at McMaster University partnered with the Society for the Study of Celiac Disease “to investigate this question, in the best possible way, which is to conduct a systematic review and meta-analysis of all studies performed to date on the topic.”

Verdu and team included 65 studies in their analysis, with over 13 million controls, 43 thousand celiac patients, 166 thousand living with IBD, and 3,000 with “indeterminate colitis.”

Forty-three of the studies were conducted in adults, 12 in children, and 9 included all ages. Most were European, but included research completed in North America and Asia.

“Our review has confirmed that there is a strong association between celiac disease and IBD, but at this time, it is unclear whether screening of IBD should be performed in celiac disease and vice versa,” said Verdu in a statement.

According to Verdu, this research confirms that there is a strong association between IBD and celiac disease.

She emphasized this finding is important because, “Failure to diagnose one or the other condition could compromise proper response to available treatments.”

Verdu added that this means doctors could consider testing “for celiac disease in a patient with IBD who remains symptomatic despite resolving colitis [inflammation of the large intestine].”

She pointed out that an evaluation for IBD could also be considered for patients with celiac who have persistent symptoms that aren’t responding well to a gluten-free diet, “despite strict compliance with this diet which is currently the only way to manage the disease.”

However, “At this moment it’s unclear whether screening of IBD should be performed in celiac disease and vice versa,” concluded Verdu. “More studies into the association of IBD and celiac disease are needed, and in that sense, our study encourages new research in this area.”

A recent study published in PLOS One finds people with IBD are much more likely to eat foods typically considered as “junk food,” including French fries and soft drinks, than those without the condition.

Researchers analyzed data from a large, nationally representative group of U.S. residents, including more than 33,000 adults aged 18 to 85 that took part in the annual National Health Interview Survey in 2015.

The survey asked participants how frequently they ate 26 different foods in the previous month. The list of foods included healthy ones like whole grains, fruits and vegetables, and much less healthy choices, such as French fries, soda, candy, and processed meats.

This isn’t to say that just eating these kinds of food will cause IBD, only that this study found that individuals with the condition tended to eat unhealthy foods more frequently.

Scientists at Kings College London have found that a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (low FODMAP) carbohydrates can improve some gut symptoms for people living with IBD.

“The low FODMAP diet is helpful for symptoms like gas, bloating, and diarrhea,” said Dr. Shannon Chang, assistant professor of medicine and gastroenterologist at NYU Langone’s Inflammatory Bowel Disease Center.

She explained other diets have been tried to manage IBD symptoms, like the:

However, none of these has been shown to be more effective than the other.

“No diet has reigned supreme in controlling symptoms, and certainly no diet has been shown to be effective in controlling inflammatory bowel disease and the inflammation associated with it,” emphasized Chang.

Research finds that IBD and celiac disease are linked — meaning that someone living with one of these conditions has increased odds of having the other one.

Experts say this is important because failing to diagnose one or the other condition in patients could compromise proper response to the available treatments.

The cause of IBD is still unknown, but there is evidence that avoiding junk food and eating a healthier diet can reduce the risk of developing this condition.

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