Abstract
BACKGROUND: Stressful events in childhood have been associated with the development of chronic gastrointestinal disorders in adulthood. However, the role of early life adverse events in patients with celiac disease has been not been investigated. AIMS: to evaluate the association between early childhood life adverse events (ELE) and gastrointestinal and extra-intestinal symptoms in patients with celiac disease (CD) compared with healthy controls (HC). METHODS: We enrolled adult patients with biopsy-proven celiac disease attending the celiac clinic at McMaster University, and sex/age-matched HC. ELE were assessed through a semi-structured interview using a modified version of the Adverse Childhood Experience questionnaire. We quantified number of ELE and the presence and severity of gastrointestinal and extra intestinal symptoms. Data are presented as Median (IQR) and n (%). Statistical analysis was performed using Mann-Whitney and Fisher’s exact tests as appropriate. Spearman test was used to assess correlation between ELE and symptoms. RESULTS: We enrolled 44 patients (25 CD patients and 19 HC). CD patients had significantly increased number of ELE compared with HC (7 (3–16) vs. 3 (1–5); p=0.003). The most frequent ELE was substance abuse in family members (CD vs HC p=0.006) and neglectful parenting (CD vs HV p=0.026) during childhood. There was a moderate correlation between ELE and severity of constipation (r(2)=0.55; p=0.01). No association was found between ELE and diarrhea, abdominal pain or other extraintestinal symptoms. CONCLUSIONS: ELE in childhood are frequently found in CD patients and may lead to symptom genesis in adulthood. The association between number of ELE and severity of constipation highlights the need for psychosocial assessment in gastroenterology clinical practice to better understand the pathophysiology of CD and potentially improve the management of these patients. FUNDING AGENCIES: None