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. 2013 Jul;48(7):808-14.
doi: 10.3109/00365521.2013.792389. Epub 2013 May 14.

Celiac disease, eosinophilic esophagitis and gastroesophageal reflux disease, an adult population-based study

Jonas F Ludvigsson  1 , Pertti Aro, Marjorie M Walker, Michael Vieth, Lars Agréus, Nicholas J Talley, Joseph A Murray, Jukka Ronkainen
Affiliations

Celiac disease, eosinophilic esophagitis and gastroesophageal reflux disease, an adult population-based study

Jonas F Ludvigsson et al. Scand J Gastroenterol. 2013 Jul.

Abstract

Objective: Celiac disease (CD) has been linked to gastroesophageal reflux disease (GORD) and eosinophilic esophagitis (EoE), but population-based studies of the prevalence of CD in these conditions are lacking, that is, the aim of this study.

Materials and methods: An endoscopic study was carried out in 1000 randomly selected adults from the general population. CD 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 EoE was defined as having at least 15 eosinophils/high-power field in biopsies from the distal esophagus. We used Fisher's exact test to compare the prevalence of GORD, esophageal eosinophilia, and EoE in subjects with CD versus controls.

Results: Four hundred subjects (40%) had gastroesophageal reflux symptoms (GORS), 155 (15.5%) had erosive esophagitis, 16 (1.6%) had Barrett's esophagus, 48 (4.8%) had esophageal eosinophilia, and 11 (1.1%) had EoE. CD was diagnosed in 8/400 (2.0%) individuals with GORS (vs. controls: 10/600 (1.7%), p = 0.81), in 3/155 (1.9%) with erosive esophagitis (vs. 15/845 controls (1.8%), p = 0.75), and in 2/48 (4.2%) individuals with esophageal eosinophilia (controls: 16/952 (1.7%), p = 0.21), but in none of those 16 with Barrett's esophagus (vs. 18/984 controls (1.8%), p = 1.0) or of the 11 individuals with EoE (controls: 18/989 (1.8%), p = 1.0).

Conclusions: This population-based study found no increased risk of CD among individuals with GORD, esophageal eosinophilia, or EoE. CD screening of individuals with GORD or EoE of individuals with CD cannot be recommended.

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Conflict of interest statement

Disclosure / Conflict of interest declaration: None

Figures

Figure 1
Figure 1. Flow chart of study participants, the population-based Kalixanda study
*Other reasons for non-participation included e.g. ischemic and other heart disease, mental/cerebral disorders, previous upper GI surgery, current malignancy, pregnancy and other severe disorders (for details, see Aro et al. [19]).
See this image and copyright information in PMC

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