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Nutrients. 2018 Oct 12;10(10). pii: E1491. doi: 10.3390/nu10101491.

Gluten and Functional Abdominal Pain Disorders in Children.

Author information

1
Mucosal Immunology and Biology Research Center, Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, 114 16th Street (M/S 114-3503), Charlestown, Boston, MA 33131, USA. allanos-chea@mgh.harvard.edu.
2
Department of Pediatrics, Harvard Medical School, Boston, MA 33131, USA. allanos-chea@mgh.harvard.edu.
3
Division of Pediatric Gastroenterology, Hepatology & Nutrition, University of Miami Miller School of Medicine, Miami, FL 33136, USA. allanos-chea@mgh.harvard.edu.
4
Mucosal Immunology and Biology Research Center, Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, 114 16th Street (M/S 114-3503), Charlestown, Boston, MA 33131, USA. afasano@mgh.harvard.edu.
5
Department of Pediatrics, Harvard Medical School, Boston, MA 33131, USA. afasano@mgh.harvard.edu.

Abstract

In children, functional gastrointestinal disorders (FGIDs) are common at all ages. Consumption of certain foods, particularly gluten, is frequently associated with the development and persistence of FGIDs and functional abdominal pain disorders (FAPDs) in adults and children. However, this association is not well defined. Even without a diagnosis of celiac disease (CD), some people avoid gluten or wheat in their diet since it has been shown to trigger mostly gastrointestinal symptoms in certain individuals, especially in children. The incidence of conditions such as non-celiac gluten sensitivity (NCGS) is increasing, particularly in children. On the other hand, CD is a chronic, autoimmune small intestinal enteropathy with symptoms that can sometimes be mimicked by FAPD. It is still unclear if pediatric patients with irritable bowel syndrome (IBS) are more likely to have CD. Abdominal, pain-associated FGID in children with CD does not seem to improve on a gluten-free diet. The threshold for gluten tolerance in patients with NCGS is unknown and varies among subjects. Thus, it is challenging to clearly distinguish between gluten exclusion and improvement of symptoms related solely to functional disorders.

KEYWORDS:

celiac disease; gluten; non-celiac gluten sensitivity; pediatric functional abdominal pain disorders; wheat

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