Can Stress Trigger Celiac Disease?

hand compressing stress ball
Can stress trigger celiac disease?. Jeffrey Coolidge/Getty Images

Can stress help to trigger celiac disease? Over the years, many people with celiac have reported their diagnoses closely followed stressful life events, including pregnancy ... and a study released in 2013 indicates they may be right.

Previous research has identified a tentative link between stressful life events and the onset of some autoimmune diseases, including rheumatoid arthritis and multiple sclerosis (but not celiac disease, which also is autoimmune in nature).

What Does the Research Show?

This latest study, conducted in Italy and published in the medical journal Nutrients, sought to see if stress might also contribute to the development of celiac disease.

The researchers compared stressful events in the lives of 186 adults with newly diagnosed celiac disease to stressful events in a control group made up of adults with a diagnosis of gastroesophageal reflux disease (GERD), which is not an autoimmune condition.

In theory, a stressful life event (such as a divorce or even a pregnancy) could relate to the onset of celiac disease one of two ways: stress could push someone to seek medical help and therefore discover they had celiac when they reported their pre-existing symptoms to their medical provider, or stress could induce or help to induce the condition directly.

The researchers in this study used a standardized questionnaire to determine "life events" — including changes in employment, education, relationships, financial status, health status, and living spaces, deaths in close relatives, criminal accusations and convictions, family and social problems and marital problems — in the last year prior to diagnosis for study participants.

They also assessed participants' gastrointestinal symptoms.

Yes, 'Life Events' Associated with Celiac Diagnosis

The researchers found that those with celiac disease were statistically more likely to have experienced one of these "life events" in the year prior to diagnosis when compared to those in the GERD control group.

This effect was even stronger when the researchers limited their analysis to those who began experiencing celiac disease symptoms only in the year prior to diagnosis — in other words, when their symptoms appeared in the same time frame as the stressful life event.

When the study authors broke the data down by gender, they found women with celiac were more likely to have a life event in their history than women in the GERD control group, but men with celiac were not.

The data analysis also identified pregnancy as a potential "life event" that precipitates celiac disease. This reinforces what many women already believe: that pregnancy can trigger celiac disease.

In addition, the study noted that more than 20% of the celiac women who reported a pregnancy said their pregnancies were stressful, while none of the women with GERD reported a stressful pregnancy.

"It is possible that celiac women could have perceived their pregnancy as a negative event more frequently than women with the control disease [GERD] because of the metabolic imbalance associated with malabsorption," the authors wrote.

However, they re-analyzed the data in an attempt to exclude problems in pregnancy, and found that "celiac women still remained more sensitive to psychosocial stressors."

So what's the bottom line? "Our study indicates that life events are associated to some degree with recent diagnosis of celiac disease in adults," the authors wrote. "The number of the events and not their severity appear as the determinant factor. Our data indicate that stressful events preceding celiac disease diagnosis are particularly frequent among celiac women, including pregnancy, which is defined as a stressful event only by celiac women and not by control women with gastroesophageal reflux."

The study supports a need for psychological support in people newly diagnosed with celiac disease, particularly in women, the authors said.

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