Background: Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder characterized by low interest in eating, sensory aversion to food, and fear of adverse reactions to food. ARFID often has overlapping symptoms with celiac disease, a chronic autoimmune disorder. To treat comorbid ARFID and celiac disease, a multidisciplinary approach is needed. While literature on this comorbidity in adults is more robust, pediatric literature is nascent, especially regarding treatments. Therefore, this study conducted a scoping review of comorbid pediatric ARFID and celiac disease to identify research gaps and future directions.
Methods: Literature was collected through PubMed, Scopus, PsycInfo, MEDLINE, Cochrane, Embase, and grey literature from celiac disease research centers. Keywords were ARFID, celiac disease, pediatric, and others. Excluded studies had participants aged >18 years, were not in English, studied other eating disorders, were published before 2013 (ARFID was added to the DSM in 2013), or were review papers. Articles were screened through Rayyan software.
Results: Six articles met inclusion criteria, including two retrospective studies, two cross-sectional studies, one book chapter, and one cohort study. While all studies included data on this comorbidity, several also studied participants with other gluten-related gastrointestinal conditions. Four studies analyzed the prevalence of ARFID and celiac disease in pediatric populations, one study evaluated the needs of children with ARFID and celiac disease, and the book chapter discussed the onset and presentation of ARFID in pediatric celiac disease.
Discussion: Results suggest there remains much to be studied in pediatric ARFID and celiac disease. Literature that assessed prevalence suggests that ARFID is commonly comorbid in pediatric celiac disease populations. However, there were no treatments studied in this population. As such, there was no research available on the multidisciplinary treatment approaches that are currently used in clinical practice. Future research should be directed towards filling this gap.