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News

No association between eosinophilic esophagitis and celiac disease

The latest Alimentary Pharmacology & Therapeutics reviews the association between eosinophilic esophagitis and celiac disease.

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The relationship between eosinophilic esophagitis and celiac disease remains controversial, with studies yielding varied results.

Dr Lucendo and colleagues from Spain systematically reviewed the evidence of a possible association between both diseases.

Electronic searches were performed with keywords relating to eosinophilic esophagitis and celiac disease in the MEDLINE, EMBASE and SCOPUS databases.

The team identified 197 references.

The researchers included 30 studies in the quantitative summary, with most of these presenting methodological inconsistencies.

Significant publication bias in favour of short studies reporting positive associations between both diseases was documented.

The prevalence of eosinophilic esophagitis in celiac disease ranged from 0% to 11%.

Prevalence of celiac disease in eosinophilic esophagitis varied between less than 1% and 57%.

The team found that 1 high-quality, prospective, randomly selected, population-based study documented a 1% prevalence of celiac disease, with no patients presenting eosinophilic esophagitis.

The researchers observed that clinical and methodological heterogeneity hindered the performance of quantitative summaries for prevalence data.

The team noted that a gluten-free diet was effective in achieving histological remission of eosinophilic esophagitis in 32% of celiac patients, which was similar to that expected for wheat elimination in eosinophilic esophagitis patients.

Dr Lucendo's team concludes, "While a lack of valid studies prevents us from completely ruling out a true association between eosinophilic esophagitis and celiac disease, currently available evidence does not support this hypothesis."

"Indeed, the only epidemiological study with sufficient validity points to the independence of both diseases."

Aliment Pharmacol Ther 2014:  Early view DOI: 10.1111/apt.12859
09 July 2014

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