title: The association of coeliac disease in childhood with functional gastrointestinal disorders: a prospective study in patients fulfilling Rome III criteria.
abstract: BACKGROUND
  An association between coeliac disease (CD) and functional gastrointestinal disorders (FGIDs) has at present only been demonstrated in adults.
  
  
  OBJECTIVE
  To assess the prevalence of FGIDs at 1 year and the role of psychological aspects on the development of FGIDs in CD children.
  
  
  METHODS
  One-hundred consecutive CD children (36M and 64F) were followed up for 1 year. Fifty-six children (25M and 31F) represented the control group. All children and/or their parents completed validated questionnaires for GI symptoms, depression, and anxiety. GI symptoms at diagnosis and after 1 year of gluten-free diet (GFD) were compared.
  
  
  RESULTS
  Twenty-three/82 (28%) CD patients followed up prospectively, on GFD from at least 1 year, fulfilled the Rome III criteria for FGIDs compared with 5/56 (8.9%) controls (P = 0.008; χ² = 6.8; OR: 3.97; 95% CI: 1.40-11.21). Children complaining with GI symptoms alone [21/52 (40.3%)] more likely fulfilled Rome III criteria for FGIDs after 1 year of GFD than children with extra-intestinal symptoms (P = 0.045). CD children with FGDIs presented significantly higher anxiety and depression compared to CD children without FGIDs and controls (P = 0.02).
  
  
  CONCLUSIONS
  This study demonstrates that children with CD on a GFD for a year have a much higher prevalence of functional GI symptoms than do controls. Whether the risk is due to the residua of a chronic inflammatory process, and/or due to psychological factors remains to be further tested.
authors.affiliation: Department of Pediatrics, University of Naples 'Federico II', Naples, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Turco
authors.forename: G
authors.initials: G
authors.lastname: Boccia
authors.forename: E
authors.initials: E
authors.lastname: Miele
authors.forename: E
authors.initials: E
authors.lastname: Giannetti
authors.forename: R
authors.initials: R
authors.lastname: Buonavolontà
authors.forename: P
authors.initials: P
authors.lastname: Quitadamo
authors.forename: R
authors.initials: R
authors.lastname: Auricchio
authors.forename: A
authors.initials: A
authors.lastname: Staiano
mesh_terms: D015746:Abdominal Pain; D000293:Adolescent; D000367:Age Factors; D016022:Case-Control Studies; D002446:Celiac Disease / Q000150:complications* / Q000178:diet therapy / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D055050:Diet, Gluten-Free; D005260:Female; D005767:Gastrointestinal Diseases / Q000178:diet therapy / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008297:Male; D008499:Medical Records; D011446:Prospective Studies