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Celiac disease, eosinophilic esophagitis and GERD

The latest issue of the Scandanavian Journal of Gastroenterology investigates the association of celiac disease, eosinophilic esophagitis and gastroesophageal reflux disease.

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Celiac disease has been linked to gastroesophageal reflux disease (GERD) and eosinophilic esophagitis, but population-based studies of the prevalence of celiac disease in these conditions are lacking.  

Dr Jonas Ludvigsson and colleagues from Sweden carried out an endoscopic study in 1000 randomly selected adults from the general population.

The research team reported that celiac disease was defined on the basis of positive serology in parallel with mucosal abnormalities of the small intestine.

Any eosinophil infiltration of the esophageal epithelium was defined as esophageal eosinophilia and eosinophilic esophagitis was defined as having at least 15 eosinophils/high-power field in biopsies from the distal esophagus.

Celiac disease was diagnosed in 8 out of 400 individuals with GERD
Scandanavian Journal of Gastroenterology

The researchers compared the prevalence of gastroesophageal reflux disease, esophageal eosinophilia, and eosinophilic esophagitis in subjects with celiac disease versus controls.

The team reported that 400 subjects had gastroesophageal reflux symptoms, 155 had erosive esophagitis, 16 had Barrett's esophagus, 48 had esophageal eosinophilia, and 11 had eosinophilic esophagitis.

Celiac disease was diagnosed in 8 out of 400 individuals with gastroesophageal reflux disease, in 3 of 155 with erosive esophagitis, and in 2 of 48 individuals with esophageal eosinophilia , but in none of those 16 with Barrett's esophagus or of the 11 individuals with eosinophilic esophagitis.

Dr Ludvigsson's team commented, "This population-based study found no increased risk of celiac disease among individuals with gastroesophageal reflux disease, esophageal eosinophilia, or eosinophilic esophagitis."

"Celiac disease screening of individuals with gastroesophageal reflux disease or eosinophilic esophagitis of individuals with celiac disease cannot be recommended."

Scand J Gastroenterol 2013: 48 (7): 808-814
15 July 2013

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