Increased Prevalence of Celiac Disease in Children with Irritable Bowel Syndrome

Main Point:

There appears to be an increased prevalence of celiac disease among children with irritable bowel syndrome (IBS).

Published in:

JAMA Pediatrics


Fernanda Cristofori, M.D., of the University of Bari, Italy, and colleagues.


Recurrent abdominal pain affects 10 percent to 15 percent of school-aged children. The prevalence of celiac disease is as high as 1 percent in European countries and patients can present with a wide spectrum of symptoms, including abdominal pain, although the disease is often asymptomatic.

How the Study Was Conducted:

The authors assessed the prevalence of celiac disease in 992 children with abdominal pain-related disorders: IBS, functional dyspepsia (indigestion) and functional abdominal pain. The final study group included 782 children: 270 with IBS, 201with functional dyspepsia and 311 with functional abdominal pain.


Blood tests were performed on all the children and 15 patients tested positive for celiac: 12 (4.4 percent) of the children with IBS, 2 (1 percent) of the children with functional dyspepsia and 1 (0.3 percent) of the children with functional abdominal pain. The prevalence of celiac among children with IBS was four times higher than the general pediatric population.


“The identification of IBS as a high-risk condition for celiac disease might be of help in pediatric primary care because it might have become routine to test for celiac disease indiscriminately in all children with recurrent abdominal pain, although our finding suggests that the screening should be extended only to those with IBS. This new approach might have important implications for the cost of care because it has been estimated that in children with FGIDs, screening tests are common, costs are substantial, and the yield is minimal.”


Fernanda Cristofori MD, Claudia Fontana MD, Annamaria Magistà MD, Teresa Capriati MD, Flavia Indrio MD, Stefania Castellaneta MD, Luciano Cavallo MD, Ruggiero Francavilla MD, PhD. Increased Prevalence of Celiac Disease Among Pediatric Patients With Irritable Bowel Syndrome: A 6-Year Prospective Cohort Study. JAMA Pediatr. 2014; 168(6):-. doi:10.1001/jamapediatrics.2013.4984

Editor’s Note:

Please see article for additional information, including other authors, author contributions and affiliations, etc.

Editorial: Role of Celiac Disease Screening for Children with Functional Gastrointestinal Disorders

In a related editorial, James E. Squires, M.D., and colleagues from Cincinnati Children’s Hospital Medical Center, Ohio, write: “Based on the study by Cristofori et al, we suggest that selective screening for celiac disease is warranted for children with IBS but not for children with other FGIDS [functional gastrointestinal disorders]. However, the lines distinguishing IBS from alternative FGIDS are often blurred. It is within this reality that pediatric health care providers should examine the evidence, evaluate the patient and family, weigh the likelihood of a false positive test result, and make the decision that they believe will benefit the patient most.”


James E. Squires MD, Lin Fei PhD, Mitchell B. Cohen MD. Role of Celiac Disease Screening for Children With Functional Gastrointestinal Disorders. JAMA Pediatr. 2014; 168(6):- doi:10.1001/jamapediatrics.2013.5418

Editor’s Note:

Please see article for additional information, including other authors, author contributions and affiliations, etc.

Media Advisory:

To contact corresponding author Ruggiero Francavilla, M.D., Ph.D., email To contact corresponding editorial author Mitchell B. Cohen, M.D., call Terry Loftus at 513-636-9682 or email

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