Abstract
Beyond the small intestine, coeliac disease (CeD) may affect other gastrointestinal
tracts, including the stomach. However, various studies have reported conflicting
results regarding the association between CeD and gastric manifestations. The aim
of this study was to analyze the existing literature on gastric involvement in CeD.
A literature search was conducted in bibliographic databases of Embase, PubMed, Scopus,
and Web of Science. Studies reporting the association between CeD and gastric disorders
were examined in detail and are fully described in the review. Both in children and
adults, a strong correlation between lymphocytic gastritis and CeD was found at CeD
diagnosis, and lymphocytic gastritis seemed to improve on a gluten-free diet. Most
of the literature described a lower risk of gastritis related to Helicobacter pylori infection in CeD subjects compared to controls. However, due to the discordance among
studies in terms of study design and population, a clear association could not be
determined. Finally, the relationship between CeD and reflux or dyspepsia has yet
to be defined, as well as the association between CeD and autoimmune gastritis. CeD
appears to be a multiform entity associated with different gastric disorders with
a different degree of relationship. Thus, gastric biopsies should be routinely taken
during upper endoscopy in CeD patients.
Keywords
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References
- The Oslo definitions for coeliac disease and related terms.Gut. 2013; 62: 43-52
- Subtypes of chronic gastritis in patients with celiac disease before and after gluten-free diet.United Eur Gastroenterol J. 2017; 5: 805-810
- The coeliac stomach: gastritis in patients with coeliac disease.Aliment Pharmacol Ther. 2015; 42: 180-187
- An association between microscopic colitis and celiac disease.Clin Gastroenterol Hepatol. 2009; 7: 1210-1216
- The association of coeliac disease and microscopic colitis: a large population-based study.Aliment Pharmacol Ther. 2011; 33: 1340-1349
- Co-occurrence of eosinophilic esophagitis and potential/probable celiac disease in an adult cohort: a possible association with implications for clinical practice.Dis Esophagus. 2016; 29: 977-982
- [Lymphocytic gastritis–a rare disorder of the gastric mucosa].Pathologe. 2001; 22: 56-61
- Lymphocytic gastritis and coeliac disease: evidence of a positive association.J Clin Pathol. 1998; 51: 207-210
- Gastrointestinal pathology in celiac disease: a case series of 150 consecutive newly diagnosed patients.Am J Clin Pathol. 2012; 138: 42-49
- Lymphocytic gastritis and celiac disease in indian children: evidence of a positive relation.J Pediatr Gastroenterol Nutr. 2008; 47: 568-572
- Lymphocytic gastritis: a positive relationship with celiac disease.J Pediatr. 1994; 124: 57-62
- Spectrum of gastritis in celiac disease in childhood.Pediatr Dev Pathol. 1999; 2: 221-226
- Increased prevalence of Helicobacter pylori infection in patients with celiac disease.Am J Gastroenterol. 2000; 95: 3682-3683
- Decreased risk of celiac disease in patients with Helicobacter pylori colonization.Am J Epidemiol. 2013; 178: 1721-1730
- Relationship between Helicobacter pylori infection and celiac disease: a cross-sectional study and a brief review of the literature.Prz Gastroenterol. 2017; 12: 49-54
- Polyautoimmunity in autoimmune gastritis.Eur J Intern Med. 2016; 31: 79-83
- Gastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet.Clin Gastroenterol Hepatol. 2011; 9: 214-219
- Gender and clinical presentation in adult celiac disease.Scand J Gastroenterol. 1995; 30: 1077-1081
- Increased prevalence of celiac disease in patients with dyspepsia.Arch Intern Med. 2000; 160: 1489-1491
- Celiac-associated peptic disease at upper endoscopy: how common is it?.Scand J Gastroenterol. 2009; 44: 1424-1428
- Gastro-oesophageal reflux symptoms and coeliac disease: no role for routine duodenal biopsy.Eur J Gastroenterol Hepatol. 2015; 27: 692-697
- Are gastric hyperplastic polyps an additional manifestation in celiac disease?: Results from a retrospective study.Medicine (Baltimore). 2017; 96: e5923
- Autoimmune gastritis: distinct histological and immunohistochemical findings before complete loss of oxyntic glands.Mod Pathol. 2002; 15: 102-109
- Common features of patients with autoimmune atrophic gastritis.Clin Gastroenterol Hepatol. 2012; 10: 812-814
- Autoimmune gastritis: relationships with anemia and Helicobacter pylori status.Scand J Gastroenterol. 2017; 52: 674-677
- Time trend occurrence of duodenal intraepithelial lymphocytosis and celiac disease in an open access endoscopic population.United European Gastroenterol J. 2017; 5: 811-818
- Organ-specific autoantibodies in coeliac disease: do they represent an epiphenomenon or the expression of associated autoimmune disorders?.Ital J Gastroenterol Hepatol. 1997; 29: 18-21
- Chronic gastritis.Scand J Gastroenterol. 2015; 50: 657-667
- Endoscopic and histologic findings in the upper gastrointestinal tract of children with coeliac disease.J Pediatr Gastroenterol Nutr. 1993; 16: 172-177
- Characterization of gastric mucosal lesions in patients with celiac disease: a prospective controlled study.Am J Gastroenterol. 1999; 94: 1313-1319
- Letter: gastritis in paediatric patients with coeliac disease.Aliment Pharmacol Ther. 2016; 44: 1003-1004
- Letter: the coeliac stomach - a significant increase in tissue transglutaminase antibodies is associated with gastritis.Aliment Pharmacol Ther. 2017; 45: 1285-1286
Dixon MF, Genta RM, Yardley JH et al. Classification and grading of gastritis. The updated Sydney System. Proceedings of the International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 1996; 20: 1161–1181
- Lymphocytic gastritis and coeliac disease.J Clin Pathol. 1990; 43: 436-437
- Lymphocytic gastritis and associated small bowel disease: a diffuse lymphocytic gastroenteropathy?.J Clin Pathol. 1995; 48: 939-945
- Lymphocytic gastritis and gastric permeability in patients with celiac disease.Gastroenterology. 1996; 111: 73-77
- Gastric permeability in celiac disease.Gastroenterology. 1997; 112: 314-315
- Lymphocytic gastritis: association with etiology and topology.Am J Surg Pathol. 1999; 23: 153-158
- Lymphocytic gastritis in pediatric celiac disease – immunohistochemical study of the intraepithelial lymphocytic component.Med Sci Monit. 2004; 10: CR38-CR42
- The immunohistochemistry profile of lymphocytic gastritis in celiac disease and helicobacter pylori infection: interplay between infection and inflammation.Mediators Inflamm. 2007; 2007: 81838
- Lymphocytic gastritis in pediatric celiac disease.Pediatr Dev Pathol. 2011; 14: 280-283
- Endoscopic and histological gastric lesions in children with celiac disease: mucosal involvement is not only confined to the duodenum.J Pediatr Gastroenterol Nutr. 2012; 55: 728-732
- Helicobacter pylori infection in children with celiac disease: prevalence and clinicopathologic features.J Pediatr Gastroenterol Nutr. 1999; 28: 143-146
- Helicobacter pylori infection in children with celiac disease.Scand J Gastroenterol. 2008; 43: 1088-1093
- Helicobacter pylori serology in patients with coeliac disease and dermatitis herpetiformis.J Clin Pathol. 1992; 45: 597-600
- Coeliac disease and follicular gastritis.Lancet. 1996; 347: 268
- Helicobacter pylori infection and peptic disease in coeliac disease.Eur J Gastroenterol Hepatol. 2000; 12: 1283-1287
- Celiac disease and Hp infection association in Iran.Rev Esp Enferm Dig. 2009; 101: 850-854
- Clinical and histological presentation of Helicobacter pylori and gluten related gastroenteropathy.Arch Iran Med. 2011; 14: 115-118
- Duodenal intraepithelial lymphocytosis is common in children without coeliac disease, and is not meaningfully influenced by Helicobacter pylori infection.Aliment Pharmacol Ther. 2014; 39: 1314-1320
- Interaction between Helicobacter pylori infection and untreated coeliac disease on gastric histological pattern.Scand J Gastroenterol. 2006; 41: 532-535
- Helicobacter pylori prevalence in patients with celiac disease: results from a cross-sectional study.Arq Gastroenterol. 2015; 52: 139-142
- Helicobacter pylori in celiac disease and in duodenal intraepithelial lymphocytosis: Active protagonist or innocent bystander?.Clin Res Hepatol Gastroenterol. 2015; 39: 740-745
- Prevalence of Helicobacter pylori infection in pediatric celiac disease.Eur Rev Med Pharmacol Sci. 2015; 19: 2031-2035
- Is There any Association Between Celiac Disease and.Euroasian J Hepatogastroenterol. 2016; 6: 103-105
- Helicobacter pylori cagA+ Is Associated with milder duodenal histological changes in Chilean celiac patients.Front Cell Infect Microbiol. 2017; 7: 376
- Helicobacter pylori infection and occurrence of celiac disease in subjects HLA-DQ2/DQ8 positive: A prospective study.Helicobacter. 2018; 23: e12465
- Celiac disease and Helicobacter pylori infection in children: Is there any Association?.J Gastroenterol Hepatol. 2017; 32: 1178-1182
- Helicobacter pylori prevalence and risk factors among children with celiac disease.Turk J Gastroenterol. 2019; 30: 284-289
- Helicobacter pylori infection in patients with celiac disease.Am J Gastroenterol. 2006; 101: 1880-1885
- Inverse associations of Helicobacter pylori with asthma and allergy.Arch Intern Med. 2007; 167: 821-827
- Helicobacter pylori infection prevents allergic asthma in mouse models through the induction of regulatory T cells.J Clin Invest. 2011; 121: 3088-3093
- Association between Helicobacter pylori and mortality in the NHANES III study.Gut. 2013; 62: 1262-1269
- Infections and autoimmunity–good or bad?.J Immunol. 2005; 174: 7481-7486
- Helicobacter pylori-induced peptic ulcer disease is associated with inadequate regulatory T cell responses.Gut. 2008; 57: 1375-1385
- CagA+ H pylori infection is associated with polarization of T helper cell immune responses in gastric carcinogenesis.World J Gastroenterol. 2007; 13: 2923-2931
- Impaired control of effector T cells by regulatory T cells: a clue to loss of oral tolerance and autoimmunity in celiac disease?.Am J Gastroenterol. 2012; 107: 604-611
- Clinical practice. Helicobacter pylori infection.N Engl J Med. 2010; 362: 1597-1604
Article Info
Publication History
Published online: April 12, 2020
Accepted:
March 10,
2020
Received:
November 19,
2019
Identification
Copyright
© 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
