Previous studies on celiac patients demonstrated that exposure to gliadin alte rs the motility of the upper gastrointestinal tract,leading to increased acid re flux. No literature is available regarding the possible p...Previous studies on celiac patients demonstrated that exposure to gliadin alte rs the motility of the upper gastrointestinal tract,leading to increased acid re flux. No literature is available regarding the possible presence of specialized intestinal metaplasia of the esophagus as a consequence of chronic reflux in adu lt celiac patients. Our purpose was to evaluate endoscopically and histologicall y the esophagi of a group of untreated celiac patients. We studied 60 celiac pat ients, 13 men and 47 women (mean age, 40 ±14 [SD] years; range, 18-80 years),a t their first endoscopy (following a normal diet). The distal esophagus was eval ua ted andmultiple biopsieswere taken. Hematoxylin-eosin and alcian blue stainin gs were performed. A group of non- celiac, age-and sex-matched patients was used as a control. We found intesti nal metaplasia in the distal esophagus of 16 of 60 (26.6%) celiacs (mean age, 4 5 ±13 years; range,27-75 years), in comparison with a control-group prevalenc e of 10.9%(OR, 3.9; 95%CI, 1.4-11.2%). Among the celiac group with metaplasi a, only one patient had reflux-like symptoms.None had esophagitis. In conclusio n, we observed an increased prevalence of esophageal metaplasia in patients with celiac disease.This finding could be the result of motor abnormalities leading to chronic acid reflux, combined with amucosa which is sensitive to gliadin.展开更多
文摘Previous studies on celiac patients demonstrated that exposure to gliadin alte rs the motility of the upper gastrointestinal tract,leading to increased acid re flux. No literature is available regarding the possible presence of specialized intestinal metaplasia of the esophagus as a consequence of chronic reflux in adu lt celiac patients. Our purpose was to evaluate endoscopically and histologicall y the esophagi of a group of untreated celiac patients. We studied 60 celiac pat ients, 13 men and 47 women (mean age, 40 ±14 [SD] years; range, 18-80 years),a t their first endoscopy (following a normal diet). The distal esophagus was eval ua ted andmultiple biopsieswere taken. Hematoxylin-eosin and alcian blue stainin gs were performed. A group of non- celiac, age-and sex-matched patients was used as a control. We found intesti nal metaplasia in the distal esophagus of 16 of 60 (26.6%) celiacs (mean age, 4 5 ±13 years; range,27-75 years), in comparison with a control-group prevalenc e of 10.9%(OR, 3.9; 95%CI, 1.4-11.2%). Among the celiac group with metaplasi a, only one patient had reflux-like symptoms.None had esophagitis. In conclusio n, we observed an increased prevalence of esophageal metaplasia in patients with celiac disease.This finding could be the result of motor abnormalities leading to chronic acid reflux, combined with amucosa which is sensitive to gliadin.
