The rate of celiac disease prevalence has been steadily rising. According to a study comparing the stored blood of soldiers with people today, it has increased up to four times within the past 50 years. Looking for the reason behind such a significant rise, many papers have been published investigating possible environmental causes, including one that found a link between celiac disease and an absence of H. pylori in the stomach. Another paper, involving three of the same doctors, found another possible explanation.
Titled “Use of proton pump inhibitors and subsequent risk of celiac disease”, the paper was accepted by Digestive and Liver Disease in August of 2013 but has not yet been published. The authors, led by first author Dr. Benjamin Lebwohl, had several lines of reasoning to look into proton pump inhibitors (PPIs) as well as histamine 2-receptor antagonists (H2RAs). First, the frequency of prescription of PPIs and H2RAs to suppress stomach acid secretion has risen in tandem with the frequency of celiac disease. Second, suppressing stomach acid secretion can affect protein digestion, increasing one’s small intestine’s exposure to protein antigens like gluten. Third, PPIs increase the permeability of the stomach which could allow gluten to be absorbed into the body to set off an immune response in a person vulnerable for developing celiac disease. Despite this potential link, this is the first study the authors are aware of looking into how PPIs may be related to celiac disease.
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