Gut transit in celiac disease: delay of small bowel transit and acceleration after dietary treatment

Abstract

Objectives: New studies indicate that body mass index (BMI) may influence gut transit. We studied gut transit and BMI in patients with celiac disease before and after treatment.

Methods: Twenty-seven (16 female) patients with untreated celiac disease were included for detailed gastrointestinal transit measurement and calculation of BMI. Ten patients (5 female) were also studied after dietary treatment. A newly developed radiological transit procedure was used. Eighty-three healthy subjects were used as controls.

Results: In untreated male patients BMI was significantly reduced compared to healthy males, and small bowel transit time (SBTT) was significantly longer compared with healthy males, 3.9 (1.2-5.5) versus 2.5 h (1.4-4.3), median and percentile 10 and 90, respectively, and p= 0.04. In the 10 men and women with repeated measurements, BMI increased significantly and small bowel transit accelerated after treatment and was 3.6 h (1.7-5.5) before treatment and 2.3 h (0.7-4.0) after treatment, and p= 0.007. In women, BMI did not differ significantly between untreated patients and healthy subjects, and 31% of the female patients were overweight. Small bowel transit was significantly faster in untreated female patients who were overweight compared with lean female patients.

Conclusion: Small bowel transit seems to be delayed in lean patients with untreated celiac disease. BMI may have some influence on the variations of small bowel transit before and after treatment.