Celiac disease in children with chronic constipation

Background/aim: Chronic constipation (CC) and celiac disease (CD) are the most common conditions encountered in pediatric gastroenterology. The association of these two disorders has not been evaluated properly. We analyzed the prevalence and outcome of CD in children with CC. Materials and methods: The study included children with CC (n = 313) and healthy children (n = 990). Serum IgA and IgA antitissue transglutaminase antibodies (IgA-tTG) were studied in all subjects. Intestinal biopsy and HLA-DQ2/DQ8 typing was performed in subjects with elevated IgA-tTG. Results: Serology was positive in 8 children (2.5%) with CC and 6 children (0.6%) from the control group (P < 0.05). Histopathological examination revealed total villous atrophy in two subjects in the control group. Other subjects had Marsh 0-1 lesions. All patients with CC and 4 children from the control group were classified as having potential CD. Two children in the control group had silent CD. Spontaneous loss of serum tTG-IgA occured in 75% of the subjects with potential CD at the end of the 1st year. Conclusion: Our study revealed that serological evaluation CD may be omitted in children with CC at initial examination. It may be perform in selected patients such as those associated with prolonged symptoms or malnutrition.