Antroduodenojejunal motor activity in untreated and treated celiac disease patients

Abstract

Background and Aim: Patients with celiac disease may present with abnormal upper gut motor activity. However, it is not known if these abnormalities persist after the introduction of a gluten‐free diet. The present study aimed to compare antroduodenojejunal motor variables recorded in untreated celiac patients with those of celiac patients given a gluten‐free diet and healthy volunteers. Methods: Eleven untreated celiac disease patients, 12 age‐ and sex‐matched celiac patients on a gluten‐free diet (at least 12 months), and 33 controls entered the study. Antroduodenojejunal motility was recorded for 6 h during fasting and for 3 h after a standard meal by means of a perfused, multiple lumen catheter. Results: More than 80% of untreated celiac patients had discrete motor abnormalities of the upper gut, in both fasting and fed recordings, compared to the other subjects. Patients on a gluten‐free diet also showed motor abnormalities, albeit to a lesser extent. In these patients histological evaluation showed the persistence of mild mucosal abnormalities. Conclusions: Upper gut motor abnormalities are frequent in patients with celiac disease, even in those on a gluten‐free diet. In the latter group, these abnormalities may suggest an incomplete adherence to the dietary regimen.