Abstract
Background
The prevalence of celiac disease and the use of medications that inhibit acid secretion
have both increased in recent decades.
Aim
To explore the association between antisecretory medication exposure and subsequent
development of celiac disease.
Methods
In this population-based case control study, we identified patients with celiac disease
diagnosed at all pathology departments in Sweden from July 2005 through February 2008.
Patients were matched by age and gender with up to 5 controls. We identified prior
prescriptions for proton pump inhibitors and histamine-2 receptor antagonists in all
subjects. We used conditional logistic regression to measure the association between
these prescriptions and the subsequent diagnosis of celiac disease.
Results
Prior proton pump inhibitor prescription was strongly associated with celiac disease
(OR 4.79; 95% CI 4.17–5.51). Patients prescribed both proton pump inhibitors and histamine-2
receptor antagonists had a higher risk of celiac disease (OR 5.96; 95% CI 3.58–9.91)
than those prescribed proton pump inhibitors alone (OR 4.91; 95% CI 4.26–5.66) or
histamine-2 receptor antagonists alone (OR 4.16; 95% CI 2.89–5.99).
Conclusions
Exposure to antisecretory medications is associated with a subsequent diagnosis of
celiac disease. The persistence of this association after excluding prescriptions
in the year preceding the celiac disease diagnosis suggests a causal relationship.
Keywords
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Article info
Publication history
Published online: September 16, 2013
Accepted:
August 6,
2013
Received:
May 14,
2013
Identification
Copyright
© 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Inc. All rights reserved.
