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Prevalence of functional gastrointestinal disorders in children with celiac disease on different types of gluten-free diets

BACKGROUND: Functional gastrointestinal disorders (FGIDs) are common during the pediatric age. FGIDs are not related to biochemical or structural abnormalities. However, since they have a high prevalence, several studies have evaluated an overlap between FGIDs and organic diseases. Individuals with...

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Autores principales: Fiori Nastro, Francesca, Serra, Maria Rosaria, Cenni, Sabrina, Pacella, Daniela, Martinelli, Massimo, Miele, Erasmo, Staiano, Annamaria, Tolone, Carlo, Auricchio, Renata, Strisciuglio, Caterina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9782836/
https://www.ncbi.nlm.nih.gov/pubmed/36569268
http://dx.doi.org/10.3748/wjg.v28.i46.6589
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author Fiori Nastro, Francesca
Serra, Maria Rosaria
Cenni, Sabrina
Pacella, Daniela
Martinelli, Massimo
Miele, Erasmo
Staiano, Annamaria
Tolone, Carlo
Auricchio, Renata
Strisciuglio, Caterina
author_facet Fiori Nastro, Francesca
Serra, Maria Rosaria
Cenni, Sabrina
Pacella, Daniela
Martinelli, Massimo
Miele, Erasmo
Staiano, Annamaria
Tolone, Carlo
Auricchio, Renata
Strisciuglio, Caterina
author_sort Fiori Nastro, Francesca
collection PubMed
description BACKGROUND: Functional gastrointestinal disorders (FGIDs) are common during the pediatric age. FGIDs are not related to biochemical or structural abnormalities. However, since they have a high prevalence, several studies have evaluated an overlap between FGIDs and organic diseases. Individuals with celiac disease (CD) have been shown to be at an increased risk for functional abdominal pain, even if they adhere well to a gluten-free diet (GFD). Little information is available for the pediatric age group. The aims of our study were to evaluate the prevalence of FGIDS in CD children 1 year after diagnosis and to compare the prevalence of FGIDs in CD children on a GFD with processed foods compared with those on a GFD with natural products. AIM: To assess the prevalence of FGIDs in children with CD after 1 year of follow-up and to compare the prevalence of FGIDs in children with CD on a GFD with processed foods and in children on a GFD with natural products. METHODS: We recruited pediatric patients aged 1-18 years with a new CD diagnosis. Participants were randomized to two groups: Group A on a GFD with processed foods (diet 1); and group B on a GFD with natural products (diet 2). Clinical monitoring, diet assessment and the questionnaire on pediatric gastrointestinal symptoms-Rome IV version were performed at diagnosis (T0) and after 12 mo of follow-up (T1). Dietary intake was assessed using a 3-d food diary record. Data from the diaries were evaluated using WinFood nutrient analysis software. We assessed the prevalence of FGIDs at T1 and the correlation with the type of GFD. RESULTS: We registered 104 CD children, with 55 patients in group A (53.0%) and 49 patients in group B (47.0%). Initially, 30 of the 55 (54.5%) CD children were symptomatic in group A, while 25 of 49 (51.0%) were symptomatic in group B. At T1, in spite of a low or negative serology for CD, FGIDs prevalence was 10/55 (18.0%) in group A and 8/49 (16.3%) in group B, with no statistically significant difference between the two groups (P = 0.780). At T1 the macro- and micronutrient intake was similar across the two groups with no significant differences in nutrient analysis. However, in both groups at T1 we found that a lower prevalence of FGIDs (P = 0.055) was associated with an inferior caloric (odds ratio = 0.99, 95% confidence interval: 0.99-1.00) and fat (odds ratio = 0.33, 95% confidence interval: 0.65-0.95) intake. CONCLUSION: Our results showed that CD children on a GFD have gastrointestinal symptoms with an elevated prevalence of FGIDs. Our study suggests that developing FGIDs may be linked to caloric intake and percentage of food fat, but it does not change between a GFD with processed foods or a GFD with natural products. However, long-term monitoring is required to evaluate a correlation between FGIDs and various types of GFDs.
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spelling pubmed-97828362022-12-24 Prevalence of functional gastrointestinal disorders in children with celiac disease on different types of gluten-free diets Fiori Nastro, Francesca Serra, Maria Rosaria Cenni, Sabrina Pacella, Daniela Martinelli, Massimo Miele, Erasmo Staiano, Annamaria Tolone, Carlo Auricchio, Renata Strisciuglio, Caterina World J Gastroenterol Randomized Clinical Trial BACKGROUND: Functional gastrointestinal disorders (FGIDs) are common during the pediatric age. FGIDs are not related to biochemical or structural abnormalities. However, since they have a high prevalence, several studies have evaluated an overlap between FGIDs and organic diseases. Individuals with celiac disease (CD) have been shown to be at an increased risk for functional abdominal pain, even if they adhere well to a gluten-free diet (GFD). Little information is available for the pediatric age group. The aims of our study were to evaluate the prevalence of FGIDS in CD children 1 year after diagnosis and to compare the prevalence of FGIDs in CD children on a GFD with processed foods compared with those on a GFD with natural products. AIM: To assess the prevalence of FGIDs in children with CD after 1 year of follow-up and to compare the prevalence of FGIDs in children with CD on a GFD with processed foods and in children on a GFD with natural products. METHODS: We recruited pediatric patients aged 1-18 years with a new CD diagnosis. Participants were randomized to two groups: Group A on a GFD with processed foods (diet 1); and group B on a GFD with natural products (diet 2). Clinical monitoring, diet assessment and the questionnaire on pediatric gastrointestinal symptoms-Rome IV version were performed at diagnosis (T0) and after 12 mo of follow-up (T1). Dietary intake was assessed using a 3-d food diary record. Data from the diaries were evaluated using WinFood nutrient analysis software. We assessed the prevalence of FGIDs at T1 and the correlation with the type of GFD. RESULTS: We registered 104 CD children, with 55 patients in group A (53.0%) and 49 patients in group B (47.0%). Initially, 30 of the 55 (54.5%) CD children were symptomatic in group A, while 25 of 49 (51.0%) were symptomatic in group B. At T1, in spite of a low or negative serology for CD, FGIDs prevalence was 10/55 (18.0%) in group A and 8/49 (16.3%) in group B, with no statistically significant difference between the two groups (P = 0.780). At T1 the macro- and micronutrient intake was similar across the two groups with no significant differences in nutrient analysis. However, in both groups at T1 we found that a lower prevalence of FGIDs (P = 0.055) was associated with an inferior caloric (odds ratio = 0.99, 95% confidence interval: 0.99-1.00) and fat (odds ratio = 0.33, 95% confidence interval: 0.65-0.95) intake. CONCLUSION: Our results showed that CD children on a GFD have gastrointestinal symptoms with an elevated prevalence of FGIDs. Our study suggests that developing FGIDs may be linked to caloric intake and percentage of food fat, but it does not change between a GFD with processed foods or a GFD with natural products. However, long-term monitoring is required to evaluate a correlation between FGIDs and various types of GFDs. Baishideng Publishing Group Inc 2022-12-14 2022-12-14 /pmc/articles/PMC9782836/ /pubmed/36569268 http://dx.doi.org/10.3748/wjg.v28.i46.6589 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Randomized Clinical Trial
Fiori Nastro, Francesca
Serra, Maria Rosaria
Cenni, Sabrina
Pacella, Daniela
Martinelli, Massimo
Miele, Erasmo
Staiano, Annamaria
Tolone, Carlo
Auricchio, Renata
Strisciuglio, Caterina
Prevalence of functional gastrointestinal disorders in children with celiac disease on different types of gluten-free diets
title Prevalence of functional gastrointestinal disorders in children with celiac disease on different types of gluten-free diets
title_full Prevalence of functional gastrointestinal disorders in children with celiac disease on different types of gluten-free diets
title_fullStr Prevalence of functional gastrointestinal disorders in children with celiac disease on different types of gluten-free diets
title_full_unstemmed Prevalence of functional gastrointestinal disorders in children with celiac disease on different types of gluten-free diets
title_short Prevalence of functional gastrointestinal disorders in children with celiac disease on different types of gluten-free diets
title_sort prevalence of functional gastrointestinal disorders in children with celiac disease on different types of gluten-free diets
topic Randomized Clinical Trial
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9782836/
https://www.ncbi.nlm.nih.gov/pubmed/36569268
http://dx.doi.org/10.3748/wjg.v28.i46.6589
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