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Dig Liver Dis. 2014 Jan;46(1):36-40. doi: 10.1016/j.dld.2013.08.128. Epub 2013 Sep 12.

Use of proton pump inhibitors and subsequent risk of celiac disease.

Author information

1
Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA; Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden.
2
Division of Gastroenterology, Department of Internal Medicine, VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, TX, USA.
3
Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
4
Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Sweden. Electronic address: jonasludvigsson@yahoo.com.

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:

Celiac disease; Proton pump inhibitors; Risk factors

PMID:
24035759
PMCID:
PMC3947159
DOI:
10.1016/j.dld.2013.08.128
[Indexed for MEDLINE]
Free PMC Article

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