Celiac disease (CeD) is a chronic condition where the immune system is triggered by consuming gluten, causing damage to the small intestine. Recent studies show that while approximately 1% of the global population has been diagnosed with CeD, a significant number of people are still undiagnosed.
CeD affects the digestive system and can cause various symptoms throughout the body. Otorhinolaryngological (ORL) – better known as ear, nose, and throat – complaints in CeD are considered rare and are often overlooked by physicians.
A recent international narrative review published in the Journal of Clinical Medicine analyzed the latest evidence on the association among CeD, ORL, and esophageal symptoms.
How did they do it?
Researchers performed PubMed database searches for articles published from 2009 to June 2023 using several keywords related to their project aims. The researchers reported on 60 original studies and 21 reviews among 97 publications found in the search results.
To gather more information on CeD, they selected additional papers from personal files and cross-referenced them with the retrieved articles. Researchers excluded articles without abstracts, case reports, commentaries, conference papers, and letters.
What did they find?
The compiled studies underlined that the prevalence of recurrent oral lesions, oral ulcers, geographic tongue (an inflammatory disorder that usually appears on the top and sides of the tongue), and dry mouth was significantly increased in CeD patients compared with healthy individuals. However, data about the other oral symptoms of CeD, such as tongue inflammation, burning mouth syndrome, inflammation of the corners of the mouth, and salivary abnormalities, are limited.
ORL conditions associated with CeD include hearing loss caused by damage to the inner ear, nasal abnormalities, and obstructive sleep apnea. Several esophageal disorders, such as acid reflux disease and inflammation of the esophagus, have been associated with CeD.
What does this mean? What does this change?
The link between ORL and esophageal manifestations and CeD should be further investigated, and a gluten-free diet’s role in improving these conditions should be clarified. Ear, Nose, and Throat specialists must be aware of the possibility of CeD in patients with ORL-related complaints. This is especially important when the patients show other symptoms that could be related to CeD. Increasing physician CeD education is important. In such cases, the specialists should consider referring these patients to a general practitioner or gastroenterologist.
Early diagnosis of CeD is crucial to treat the disease and work to avoid long-term complications.
Keep reading to learn more about the study.
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