Published online Dec 14, 2022. doi: 10.3748/wjg.v28.i46.6589
Peer-review started: May 23, 2022
First decision: June 19, 2022
Revised: July 3, 2022
Accepted: November 2, 2022
Article in press: November 2, 2022
Published online: December 14, 2022
Processing time: 198 Days and 17.2 Hours
When an organic disorder, like celiac disease (CD), is present, functional gastrointestinal disorders (FGIDs) cannot be diagnosed. However, these disorders have a high prevalence. Therefore, a number of studies have assessed the possibility of overlap between FGIDs with organic disorders.
Few data are available regarding the risk of FGIDs in children strictly adhering to a conventional gluten free diet (GFD).
The objectives of this study were to estimate the prevalence of FGIDs in patients affected by CD at the moment of the diagnosis (T0) and after 1 year of follow-up (T1) comparing two different types of GFD.
This study involved 104 celiac pediatric patients (aged 1 year to 18 years) randomized to: Group A, on a GFD with processed foods; and group B, on a GFD with natural products. Clinical follow-up, a 3-d dietary diary evaluation and a questionnaire based on the Rome IV criteria were completed for each child at T0 and T1. We examined the FGIDs after 12 mo and the relationship to the type of GFD.
At the time of enrollment, 54.5% of CD children had symptoms in group A, and 51.0% of CD children had symptoms in group B. At T1, in spite of low or negative CD serology, the prevalence of FGIDs was 18.0% in group A and 16.3% in group B (P = 0.780). In both groups after 12 mo of a GFD an intraindividual analysis showed a significantly lower prevalence of FGIDs (P = 0.055) in patients lower calorie and fat intake.
Many children still have gastrointestinal symptoms and FGIDs despite a strict GFD, and it could be linked to the caloric intake and the amount of fat in the diet. However, it does not seem affected by a GFD with commercial or natural products.
To evaluate the correlation between FGIDs and different types of GFDs, long-term monitoring is necessary.