title: Abdominal Pain-Associated Functional Gastrointestinal Disorder Prevalence in Children and Adolescents with Celiac Disease on Gluten-Free Diet: A Multinational Study.
abstract: To test the hypothesis that children with celiac disease (CD) on gluten-free diet are at increased risk of abdominal pain (AP) associated-functional gastrointestinal disorders (FGIDs).
  
  
  
  This was a multinational cross-sectional study performed from 2014 to 2015. Patients 4-18 years of age with CD on gluten-free diet for longer than 6 months were recruited from pediatric CD clinics in US and Italy. Control groups included siblings of children with CD (with normal tissue transglutaminase levels) and unrelated controls. Subjects or parents completed the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III.
  
  
  
  Children (n = 289) were recruited (55% US, 45% Italy): 96 children with CD, 96 sibling controls, and 97 unrelated controls. Chronic AP was present in 30 (30.9%) subjects with CD, 22 (22.7%) sibling controls, and 21 (21.6%) unrelated controls (P = .26 patients with CD vs siblings; P = .18 patients with CD vs unrelated; P = .96 siblings vs unrelated). AP-FGIDs were present in 8 (8.2%) subjects with CD, 8 (8.2%) sibling controls, and 2 (2.1%) unrelated controls (P = 1.00 subjects with CD vs sibling controls; P = .06 subjects with CD vs unrelated controls; P = .06 sibling controls vs unrelated controls).
  
  
  
  This multinational study evaluated the prevalence of chronic abdominal pain and AP-FGIDs in the pediatric population with CD. We found that subjects with CD and controls have a similar prevalence of chronic AP and AP-FGIDs. This suggests that not all types of gastrointestinal inflammation result in AP-FGIDs in children.
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH.
authors.forename: Miguel
authors.initials: M
authors.lastname: Saps
authors.affiliation: Department of Pediatrics, University of Verona, Verona, Italy.
authors.forename: Naire
authors.initials: N
authors.lastname: Sansotta
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH. Electronic address: sean.bingham@nationwidechildrens.org.
authors.forename: Sean
authors.initials: S
authors.lastname: Bingham
authors.affiliation: Pediatric Gastroenterology, University of Messina, Messina, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Magazzu
authors.affiliation: Department of Pediatrics, University of Messina, Messina, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Grosso
authors.affiliation: Department of Internal Medicine, University of Verona, Verona, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Romano
authors.affiliation: Division of Pediatric Gastroenterology Hepatology & Nutrition, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
authors.forename: Cenk
authors.initials: C
authors.lastname: Pusatcioglu
authors.affiliation: Department of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Chicago Celiac Disease Center, The University of Chicago Medicine, Chicago, IL.
authors.forename: Stefano
authors.initials: S
authors.lastname: Guandalini
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000453:epidemiology*; D000293:Adolescent; D017677:Age Distribution; D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D055050:Diet, Gluten-Free; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D038622:Internationality; D008297:Male; D015995:Prevalence; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution
keywords: Italy; Rome III; United States; chronic abdominal pain; functional abdominal pain; functional dyspepsia; irritable bowel syndrome; pediatric; tissue transglutaminase