Bowel Illnesses Sometimes Coincide in Kids
Children with irritable bowel syndrome were more likely to also have celiac disease in Italian study
Identifying irritable bowel syndrome as a high risk for celiac disease might make screening routine for children with the condition, while not screening all children with chronic stomach pain, Francavilla said.
While the study found a link between having inflammatory bowel syndrome and a higher risk for celiac disease in children, it did not prove a cause-and-effect relationship.
The report was published online April 21 in JAMA Pediatrics.
Dr. Mitchell Cohen, co-author of an accompanying journal editorial, said, "We can help diagnose and treat children with celiac disease by screening children with irritable bowel syndrome. However, if the approach is not selective, many children will have false-positive test results that will cause more endoscopy and false worry."
Routine screening for celiac disease of any child with chronic stomach pain is not recommended. However, selective screening of children with irritable bowel syndrome is recommended, said Cohen, vice-chair of pediatrics for clinical affairs at Cincinnati Children's Hospital Medical Center.
Another expert takes a broader view of screening for celiac disease.
Dr. William Muinos, co-director of the division of gastroenterology at Miami Children's Hospital, said, "We always think of the possibility of celiac disease in children with chronic abdominal pain and some bowel dysfunction."
Muinos added that it's hard to tell the difference between irritable bowel syndrome and other causes of stomach pain. "It's a lot of medical history, and perception of the physician."
In his own practice, Muinos said, he screens most for celiac disease in children who have chronic pain and other symptoms, such as bowel bleeding or vomiting.
"Celiac disease can cause symptoms of irritable bowel syndrome," Muinos said. "Celiac disease is something you can treat once you find it," he said.