Are Celiac Disease & Inflammatory Bowel Disease Linked?

While patients with inflammatory bowel disease (IBD) often also can have celiac disease, new research shows there is no association between the 2 gastrointestinal disorders.

Kenny Walter, 1

A team, led by Mamdouh Qadi, identified the prevalence of celiac disease in pediatric patients with IBD in Saudi Arabia.

While this link is largely unknown, some research has indicated the coexistence of celiac and IBD in the same patients.

“Some instances of the simultaneous coexistence of both diseases in the same patient have been described in the literature, and physicians generally suspect a link between CeD and IBD; however, no clear association has been established to date,” the authors wrote.

The Study
In the retrospective study, the investigators examined data on patients with IBD in the Pediatric Gastroenterology Department at the National Guard Hospital in Jeddah, Saudi Arabia.

Patients included in the study were between 1-18 years old who had been diagnosed with IBD and celiac disease, based on positive biochemical serology and histology between January 2011 and January 2020. The median patient age was 14 years, while 56.9% (n = 29) of the patient population had Crohn’s disease and 33.3% (n = 17) of the patients had ulcerative colitis.

In addition, the majority of patients included in the study were diagnosed in 2016, 2017, and 2019.

Each patient were recommended to undergo an ileocoloscopy and upper gastrointestinal endoscopy, while inflamed and non-inflamed mucosa biopsies were taken from each segment of the gastrointestinal tract.

Patients with immunodeficiency disorders were excluded from the study. The investigators also used a consecutive non-probability sampling technique to collect data from the patients’ physical and electronic files.

Overall, there were 46 patients with IBD included in the analysis, but only 4 of which also had celiac disease. These patients did not develop any relapses.

The investigators found the weight at IBD diagnosis improved significantly compared to current weight (P <.0001) and height at diagnosis of IBD improved significantly compared to the current height (P <.0001).

However, there was no significant associations between ulcerative colitis and celiac disease (P = 1) or Crohn’s disease and celiac disease (P = .625).

“No significant associations were evident between the prevalence of CeD and IBD,” the author wrote. “More prospective multicenter studies are needed to clarify the prevalence of CeD in children with IBD.”

Celiac disease is 1 of the more common immune-mediated diseases, with about 1% of the population in US and Europe diagnosed with the disease. However, the global prevalence has not been studied extensively.

However, the link between IBD and celiac has been hypothesized because of the prevalence of both diseases and the theoretically similar pathogenesis of the conditions given the interaction of genetic, immunological, and environment factors like gut flora or gastroenteritis.