Gut microflora associated characteristics in children with celiac disease

Am J Gastroenterol. 2005 Dec;100(12):2784-8. doi: 10.1111/j.1572-0241.2005.00313.x.


Objectives: The aim of the study was to investigate the metabolic function of intestinal microflora in children with celiac disease (CD) in order to find out if there is a deviant gut flora in CD patients compared to healthy controls.

Methods: The study group comprised children with CD, consecutively diagnosed according to current criteria given by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition. Thirty-six children were studied at presentation, i.e., on a normal gluten-containing diet, with clinical symptoms and signs indicative of CD, positive celiac serology markers, and a small bowel biopsy showing severe enteropathy. Forty-seven patients were studied when they had been on a gluten-free diet (GFD) for at least 3 months. For comparison, a group of 42 healthy controls (HC) were studied. The functional status of the intestinal microflora was evaluated by gas-liquid chromatography of short chain fatty acids (SCFAs) in fecal samples.

Results: There was a significant difference between untreated CD children and HC as well as between treated CD children and HC regarding acetic, i-butyric, i-valeric acid, and total SCFAs. The propionic and n-valeric acids differed significantly between CD children on GFD and HC. Moreover, there was a strong correlation between i-butyric and i-valeric acids in all study groups.

Conclusions: This is the first study of the SCFA pattern in fecal samples from children with CD. The results indicate that there is a difference in the metabolic activity of intestinal microbial flora in children with CD compared to that in HC. The finding of a different pattern of some SCFAs in celiacs both at presentation and during treatment with GFD indicates that it is a genuine phenomenon of CD not affected by either the diet, the inflammation, or the autoimmune status of the patient.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / analysis
  • Biopsy, Needle
  • Case-Control Studies
  • Celiac Disease / diagnosis*
  • Celiac Disease / diet therapy*
  • Child
  • Child, Preschool
  • Chromatography, Gas
  • Diet Therapy / methods
  • Fatty Acids, Volatile / analysis*
  • Female
  • Glutens
  • Humans
  • Immunohistochemistry
  • Infant
  • Intestinal Mucosa / microbiology
  • Intestinal Mucosa / pathology
  • Intestines / microbiology*
  • Intestines / pathology
  • Male
  • Probability
  • Prognosis
  • Reference Values
  • Sensitivity and Specificity


  • Biomarkers
  • Fatty Acids, Volatile
  • Glutens