Portal Hypertension and Celiac Disease: Evolution Of Portal Hypertension With a Gluten Free Diet

Aims Celiac disease (CD) is immune-mediated multisystem disorder that may affect several organ induced by the ingestion of gluten. The association with portal hypertension (PH) is rare. The aim of our work is to describe the association between PH and CD and to study the influence of the gluten-free diet (GFD) on the evolution of PH.

Methods This is a retrospective study over a period of 20 years, involving 20 patients with CD and PH out of a total of 304 celiac patients. The diagnosis of CD was based on histological (LEL ≥ 30 %) and serological criteria.

Results 20 patients were collected, the sex ratio F/M was 3. The mean age was 34.2 years (19-60). Gastroduodenal endoscopy was performed. Esophageal varices (OV) were found in 55 %: OV grade 1 in 30 %, OV grade 2 in 20 % and OV grade 3 in 5 %, red signs were present in 10 %. abdominal doppler ultrasonography showed port-systemic CVC, a homogeneous liver in 65 %, heterogeneous liver with spiculate contours in 35 %, a portal cavernoma in 25 %, and focal thrombosis of IVC in one case. Common causes of chronic liver disease were excluded in all patients. Hepatic histology was performed revealing:MVPS (porto-sinusoidal vascular disease) in 40 %,celiac cirrhosis in 20 %, granulomatous hepatitis associated with CD in 15 %,normal in 21 %. OV ligation until eradication was performed in 10 %, primary prevention with B-blockers was instituted in 27 %. An endoscopic control was performed after 2 years of GFD and showed the disappearance of OV in 45 % with good adherence of GFD, while in 55 %, a reappearance of OV was noted in those who did not adhere to the GFD.

Conclusions Our study has shown that the association between CD and PH is not rare (6.5 % in our series). The commitement to a GFD has a beneficial effect on the evolution and severity of PH.

Citation: Chbourk S, Borahma M, Benelbarhdadi I et al. eP8 PORTAL HYPERTENSION AND CELIAC DISEASE: EVOLUTION OF PORTAL HYPERTENSION WITH A GLUTEN FREE DIET. Endoscopy 2021; 53: S99.

Publication History

Article published online:
19 March 2021