Coeliac disease a risk factor for inflammatory bowel disease
Patients with coeliac disease have more than an 11-fold increased risk of developing inflammatory bowel disease (IBD), whereas those with IBD have only a twofold higher risk of developing coeliac disease, a study has found.
Researchers performed a systematic review and meta-analysis of studies investigating the association between coeliac disease and IBD. Only studies that reported original data, used clinically established methods to diagnose coeliac disease or IBD, and reported on the prevalence rate of IBD in coeliac disease or vice versa were included.
The analysis included 27 studies corresponding to 41,482 adult IBD patients (20,357 with Crohn’s disease; 19,791 with ulcerative colitis), 1,295 non-IBD controls, 2,769 patients with coeliac disease and 4,854 controls without coeliac disease.
Based on pooled data, the prevalence rate of coeliac disease in IBD patients was 1,110 (95 percent CI, 1,010–1,210) per 100,000 as compared with 620 (610–630) per 100,000 in non-IBD controls (odds ratio [OR], 2.23; 1.99–2.50). This effect did not differ between ulcerative colitis and Crohn’s disease.
On the other hand, the prevalence of IBD in patients with coeliac disease was 2,130 per 100,000 as compared with 260 (250–270) per 100,000 in the corresponding control population (OR, 11.10; 8.55–14.40).
Funnel plot indicated that the risk of IBD in coeliac disease was possibly influenced by publication bias, while there was no evidence for publication bias for the risk of coeliac disease in IBD.
While the exact mechanism of the association between coeliac disease and risk of IBD has yet to be explored, researchers postulated that it may be related to the mucosal inflammation associated with coeliac disease. This inflammation in turn initiates a sequel of events that ultimately result in IBD.