What’s the Link Between EoE and Celiac Disease?

in Celiac, News
Published: June 7, 2018

A large analysis of more than 35 million patients found an intriguing connection between celiac disease and eosinophilic esophagitis. Out of the 15,000 patients in a database pulled from 360 U.S. hospitals who had been diagnosed with EoE, 2 percent also had celiac disease.

The numbers translate into a likelihood nine times larger of finding celiac disease in a patient with EoE compared to a patient in the general population. Dr. Emad Mansoor, of University Hospitals of Cleveland Medical Center, presented the research in 2018 at the World Congress of Gastroenterology. The study was later published.

Mansoor said the diseases share some characteristics of development: they both have autoimmune, genetic and environmental causes. In celiac disease, for example, the trigger is gluten. The triggers for eosinophilic esophagitis are less clear. Although there are some common foods that gastroenterologists will eliminate from a patient’s diet to identify triggers.

EoE and Celiac: Is There a Link?

Mansoor has patients in his clinic with both diseases. He undertook the analysis after a review of research showed conflicting data on whether a relationship exists.

He says his study’s results suggest patients with EoE should be screened for celiac disease.

However, this research has led to more investigation and further differences of opinion the relationship of the two diseases. One 2023 study looked at patients with celiac disease and eosinophilic esophagitis compared to those with celiac disease or eosinophilic esophagitis alone. It concluded that, due to a lack of distinguishing features in the group with both disorders, the occurrence of both diseases is likely coincidental.

Then an Italian study of more than 300 children with celiac disease found that while those children were more likely than the general population to have a high rate of eosinophils in the esophagus. But it said this didn’t mean the kids had EoE. The authors concluded: “we do not recommend routine esophageal biopsies unless clinically indicated.” Given the conflicting opinions, expect to see more study of this topic. –Article updated November 2023.

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Read more:
All About EoE (Eosinophilic Esophagitis)
Expert Q&A: Dupilumab Approved for EoE
Development of EoE Linked with Eczema, Asthma and Food Allergy