The frequency of celiac disease in children with chronic constipation

Objective: To investigate the frequency of celiac disease (CD) in children with chronic constipation unresponsive to conventional treatment Design: A retrospective study Setting: Clinics of Pediatric Gastroenterology, Mersin City Training and Research Hospital, Mersin, Turkey Subjects: Six hundred and sixty-two pediatric patients between the ages of 2 and 18 who were diagnosed with chronic constipation according to Rome III criteria and did not respond to conservative treatments were included in the study. Interventions: All patients underwent tissue transglutaminase antibody (tTG) IgA and total IgA tests. The cut-off value of tTG IgA is 20 U/ml. Esophago-gastroduodenoscopy was performed on all patients with tTG positivity. Main outcome measure: All patients were evaluated in regards to celiac disease. Results: Of the 662 patients (341 girls), the mean age was 6.48 +/- 4.32 years. The mean tTG IgA value was 7.07 +/- 17.33 U/ml and the mean total IgA value was 107.37 +/- 64.74 mg/dl. tTG positivity was detected in 22 patients (3.32%) and six of them refused endoscopy. Gastroduodenoscopy was performed to the other patients. The pathological biopsy results of nine patients (1.36%) were consistent with Marsh 3 classification score and those were diagnosed with CD. The pathological biopsy results of the other seven patients were consistent with Marsh 0 classification score. Conclusion: We found that the prevalence of CD was three times higher in children with functional constipation than in the general population. Therefore, we suggest that serologic tests for CD should be considered in children with functional constipation unresponsive to conventional treatment.