Screening for celiac disease in patients with eating disorders

Abstract

In this cohort of patients being evaluated for an ED, 0.8% had biopsy confirmed CD. This is similar to the reported prevalence in the general population, suggesting that routine screening of patients with EDs for CD is not indicated. We still need to be vigilant, however, for subtle symptoms that may indicate underlying CD in a small percentage of patients with EDs.

Differential Diagnoses of Food-Related Gastrointestinal Symptoms in Patients with Anorexia Nervosa and Bulimia Nervosa: A Review of Literature

“…Based on the available current literature, it may be assumed, that most GI complaints in ED patients meet the criteria for FGIDs, while the prevalence of structural and immunological disorders or food intolerance in ED patients is similar to the general population (CD 0.5-1% (Basso et al 2013), food allergy in adults 1-3% and in children 4-7% (Turnbull 2015), food intolerance: fructose 15-25%, sorbitol 8-12%, lactose 7-20% (Raithel 2013), IBD 0.5% in Europe, 0.3% in North America (Molodecky et al 2012), Achalasia 0.002% (O'Neill et al 2013)). However, there are no studies specifically evaluating the prevalence of food allergies and food intolerance in ED patients, with the exception of CD in ED, which showed a prevalence comparable to the general population (0-0.8% in ED (Kaltsa et al 2015;Raevuori et al 2014;Saldanha et al 2016)). A limitation, however, is that other food associated diseases were not finally excluded by diagnostic testing in all studies on FGIDs presented here.…”

“…If the screening test was positive, the diagnosis was confirmed by biopsy. The authors reported a prevalence of 0% (n = 154), 0.8% (n = 494), and 0.6% (n = 177), respectively (Kaltsa et al 2015;Saldanha et al 2016;Basso et al 2013). Raevuori et al (2014) performed data analyses of the medical files of 2326 ED patients.…”

A systematic review and meta‐analysis of the prevalence and odds of eating disorders in patients with celiac disease and vice‐versa

“…Additional screening of the studies yielded 114 full texts checked against eligibility criteria. Finally, 23 observational studies were included (Figure 1; Arigo et al, 2012; Basso et al, 2013; Butwicka et al, 2017; Garud et al, 2009; Hedman et al, 2018; Kaltsa et al, 2015; Karwautz et al, 2008; Latzer, Lerner‐Geva, et al, 2018; Latzer, Rachmiel, et al, 2018; Lebwohl et al, 2020; Leffler et al, 2007; Marild et al, 2017; Nacinovich et al, 2017; Passananti et al, 2013; Pynnönen et al, 2004; Raevuori et al, 2014; Saldanha et al, 2018; Satherley et al, 2016; Vaknin et al, 2004; Wagner et al, 2015; Welch et al, 2015; Wotton et al, 2016; Zriouel et al, 2020). Table 1 presents the characteristics of the included studies.…”

“…Numerous studies had also investigated the prevalence and risk of EDs in children and adults with CD and reported the mixed results (Arigo, Anskis, & Smyth, 2012; Basso et al, 2013; Butwicka et al, 2017; Garud et al, 2009; Hedman et al, 2018; Kaltsa et al, 2015; Karwautz et al, 2008; Latzer, Rachmiel, et al, 2018; Latzer, Lerner‐Geva, Stein, Weiss, & Pinhas‐Hamiel, 2018; Lebwohl et al, 2020; Leffler et al, 2007; Marild et al, 2017; Nacinovich et al, 2017; Passananti et al, 2013; Pynnönen et al, 2004; Raevuori et al, 2014; Saldanha, Weiselberg, & Fisher, 2018; Satherley, Howard, & Higgs, 2016; Vaknin, Eliakim, Ackerman, & Steiner, 2004; Wagner et al, 2015; Welch, Ghaderi, & Swenne, 2015; Wotton, James, & Goldacre, 2016; Zriouel, Cherkani‐Hassani, Khadmaoui, & Ettair, 2020).…”

The intersect of gastrointestinal symptoms and malnutrition associated with anorexia nervosa and avoidant/restrictive food intake disorder: Functional or pathophysiologic?—A systematic review

“…Although the above studies suggest celiac disease contributes to disordered eating, several authors suggest lack of increased prevalence of celiac disease in those with EDs (Basso et al, 2013;Kaltsa et al, 2015;Pynnönen et al, 2002;Saldanha et al, 2016) (Table 6). In contrast, and when examining cohorts of solely patients with AN, Welch et al (2015) found a prevalence of 2.4% of individuals (14 females) meeting criteria for biopsy-confirmed celiac from a sample of 572 patients with AN and atypical AN.…”