Young women with celiac disease are more likely to suffer from anorexia, and vice versa. Symptoms similar to these two pathologies can lead to a delay in diagnosis.
Women with celiac disease are 4.5 times more likely to have anorexia before age 19 than other women, reports a large Swedish study published in Pediatrics.
This association between gluten intolerance and this serious eating disorder has long been suspected, but little work has really looked into it. For their study, the team led by Karl Mårild of the University of Colorado analyzed the medical records of nearly 18,000 women with celiac disease and 80,000 healthy women. This information was collected between 1969 and 2008 in Sweden.
The study reveals that after a diagnosis of celiac disease, patients are 46% more likely to have anorexia. Conversely, after a diagnosis of anorexia, women are twice as likely to be treated for gluten intolerance later in life.
Wandering diagnosis
The authors explain that this work was not designed to show that celiac disease promotes anorexia, or the other way around. But the fact that this association is bidirectional suggests that the patients are misdiagnosed in the first years of their disease because the gastrointestinal disorders caused by these two pathologies are close, explain the authors. Indeed, both cause abdominal pain, diarrhea, fatigue or stunted growth.
In addition, the authors explain that dietary restrictions of the gluten-free diet can also promote the onset of eating disorders that can lead to anorexia.
Diseases that appear in adolescence
In a commentary accompanying the study, Dr. Neville Golden, pediatrician at Stanford University, points out that these errors or delay in diagnosis occur during adolescence. “However, this is a particularly vulnerable period of development and growth”, he notes, adding that in view of these results “these erroneous diagnoses can have disastrous effects on the patient such as bone diseases, a quality life impacted, even early mortality. “
Also to improve the diagnosis of anorexia and gluten intolerance, the American pediatrician calls on his colleagues to think about these two diseases, especially when they are faced with patients who do not respond to standard treatments.
In France, between 0.7 and 2% of the population would be affected by gluten intolerance. For its part, anorexia affects 0.5% of girls and 0.03% of boys between 12 and 17 years old.
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