ABNORMALITIES OF THE ENTERIC NERVOUS SYSTEM, SMOOTH MUSCLE AND INTERSTITIAL CELLS OF CAJAL IN CHILDREN WITH COLONIC MOTILITY DISORDERS

Aim: To identify from Avon Longitudinal Study of 14,000 Parents and Children (ALSPAC) children who had been formally diagnosed as Coeliac Disease (CD) and compare this with serological screeing data.Background: 5470 children randomly selected from a total of 14,000 were screened using Tissue Transglutaminase (TTG) and IgA endomysial antibodies (EMA).54 children proved positive for CD suggesting a prevalence of 1% (1).ALSPAC is an anonymous study and hence these children have not been referred for biopsy or told the results.Within Avon all children with suspected or serologically positive CD are referred to just one centre, Bristol Children`s Hospital, for small bowel biopsies.Methods: Since 1990, data has been prospectively collected on all children having endoscopic small bowel biopsy for CD.This data and centralised computer and dietetic records within Avon have been analysed to identify ALSPAC children with CD (date of birth 01.04.1991Y31.12.1992 and Avon postcodes).Results: 12 children from Avon diagnosed with CD since 1.4.91,have birthdays concordant with ALSPAC.This gives a prevalence rate of 1/1,100.All had symptoms.Four had a family history.At time of diagnosis all were aged over 2 years, 3 were 2Y5 yr, 6 were 5Y10 yr and 3 were aged 10Y14 yrs.Discussion: Based on screening data, 140 children from Avon would be expected to have CD.However only 12 of these children have been diagnosed with CD.This suggests that 90% of children with possible CD may be being missed.The screening data also recorded that children with positive screening tests were lagging behind in growth by 9 months.There are other well documented long term health hazards of untreated CD.Our data suggests all children should be screened for CD.