Yang A et al. (2005) Inflammatory bowel disease in patients with celiac disease. Inflamm Bowel Dis 11: 528–532

Celiac disease is common; according to serologic screening, it occurs in 1% of the global population. Several case reports and case series have suggested a link between celiac disease and inflammatory bowel disease (IBD); however, no studies have specifically examined this relationship.

A group based in New York reviewed the incidence of IBD among 455 patients whose data were included in an anonymized celiac-disease database between 1981 and 2002. Eligible patients were at least 18 years old and had responded positively to a gluten-free diet. A clinical history of IBD was confirmed both endoscopically and pathologically.

Crohn's disease was identified in five patients and ulcerative colitis in another five. These results represented an age-adjusted and sex-adjusted prevalence ratio of 3.56 for ulcerative colitis and 8.49 for Crohn's disease—significantly higher than in the general population. The higher rates of these diseases in these patients with celiac disease might be partly explained by the fact that the center that conducted the study receives a high rate of referrals of patients with complicated histories of celiac disease. A significant number of this center's patients are also of Jewish ancestry, a group known to have a higher incidence of IBD. Despite these potential biases, the authors comment that this study adds to previous information suggesting an association between celiac disease and IBD, although its impact on the course of celiac disease remains to be assessed.