Wieser Herbert, Ciacci Carolina, Gizzi Carolina, Santonicola Antonella
Hamburg School of Food Science, Institute of Food Chemistry, University of Hamburg, 20146 Hamburg, Germany.
Gastrointestinal Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84131 Salerno, Italy.
J Clin Med. 2023 Nov 10;12(22):7036. doi: 10.3390/jcm12227036.
Celiac disease (CeD) is a chronic gluten-sensitive immune-mediated enteropathy characterized by numerous intestinal and extra-intestinal signs and symptoms. Among extra-intestinal manifestations, otorhinolaryngological (ORL) complaints in CeD are relatively rare and their relation to CeD is frequently overlooked by physicians. Recent studies underlined that the prevalence of recurrent aphthous stomatitis, aphthous ulcers, geographic tongue, and xerostomia was significantly increased in CeD patients compared with healthy individuals. However, data about the other oral manifestations of CeD, such as atrophic glossitis, glossodynia, angular cheilitis, and salivary abnormalities, are scanty. Further ORL conditions associated with CeD include sensorineural hearing loss, nasal abnormalities, and obstructive sleep apnea. Moreover, several esophageal disorders such as gastroesophageal reflux disease and eosinophilic esophagitis have been associated with CeD. The pathophysiological link between both ORL and esophageal manifestations and CeD might be further investigated. In addition, also the role of gluten-free diet in improving these conditions is largely unclear. Certainly, otorhinolaryngologists can play an important role in identifying people with unrecognized CeD and may help prevent its long-term complications. The aim of this narrative review is to analyze the latest evidence on the association between CeD and ORL and esophageal manifestations.
乳糜泻(CeD)是一种慢性麸质敏感的免疫介导性肠病,其特征为众多肠道和肠道外的体征及症状。在肠道外表现中,CeD患者的耳鼻喉科(ORL)主诉相对少见,且医生常常忽视其与CeD的关系。近期研究强调,与健康个体相比,CeD患者复发性阿弗他口炎、阿弗他溃疡、地图舌和口干症的患病率显著增加。然而,关于CeD的其他口腔表现,如萎缩性舌炎、舌痛、口角炎和唾液异常的数据却很匮乏。与CeD相关的其他ORL病症包括感音神经性听力损失、鼻腔异常和阻塞性睡眠呼吸暂停。此外,一些食管疾病,如胃食管反流病和嗜酸性粒细胞性食管炎也与CeD有关。ORL和食管表现与CeD之间的病理生理联系可能需要进一步研究。此外,无麸质饮食在改善这些病症方面的作用也在很大程度上尚不清楚。当然,耳鼻喉科医生在识别未被诊断的CeD患者方面可以发挥重要作用,并可能有助于预防其长期并发症。本叙述性综述的目的是分析关于CeD与ORL及食管表现之间关联的最新证据。
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