Imad Absah, M.D., discusses a recently published article in the Journal of Pediatric Gastroenterology and Nutrition about mucosal healing in children with celiac disease. The results show that children with celiac disease may not have as complete mucosal healing as previously thought.
There is no test to detect the rate of mucosal healing. The rate of healing in children has historically been within 6 - 12 months of beginning a gluten-free diet. This study looked at hospital records between 1997 and 2013. The researchers identified all the children with celiac disease and looked into the records that showed repeat biopsies. The researchers found 40 children out of 222, about 18%, had a small bowel biopsy repeated. The time frame between the first and second biopsy was 24 months.
The results showed only 25 of the children had complete healing. 9 of the children had mild inflammation with intraepithelial lymphocytes and 6 had persistent villous atrophy. The researchers did not find any correlation between the symptoms and villous atrophy. There were 20 patients with abdominal pain and only 2 had persistent injury to the gut.
Downsides of the study are it's retrospective, a small sample size, and most of the children with repeat biopsies has symptoms. Most of the children had abdominal pain, diarrhea, and constipation.
In this selected group of patients treated celiac disease, only 64% had complete healing of the gut. There was no correlation between the persistent symptoms and mucosal healing.
Read the full study online here.
For more information on celiac disease, visit mayoclinic.org/celiacdisease.
Dr. Absah is a pediatric gastroenterologist at Mayo Clinic.
Interested in learning more about research studies, opportunities, and study results? Visit the National Foundation for Celiac Awareness' Research Opt-In.