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Study Objective: to identify the key clinical and diagnostic markers of comorbidity presenting the risk of biliary pathology in celiac syndrome patients. Study Design: screening observation. Materials and Methods. The study included 133 patients with confirmed celiac syndrome and biliary dysfunction. Subjective clinical symptoms were analysed on the basis of reviews and questionnaires, while objective clinical symptoms were assessed following physical examination. When clinical symptoms were characterised, presence of subjective clinical criteria of functional disorders of gall bladder (GB) and Oddi’s sphincter were assessed. Study Results. Specific markers of biliary dysfunction in patients with celiac syndrome were identified. Following IV Rome criteria (2016), it was determined that subjective symptoms in some patients were signs of biliary indigestion syndrome: aches in right hypochondrium (45.1%), bitter taste in mouth (36.1%), nausea (36.1%). Subject had ultrasound signs on GB pathologies: bends in GB body (31.6%), GB neck (35.3%) and both (33.1%). Celiac syndrome patients had significant correlation between duodenitis severity and morphological characteristic of the major duodenal papilla. Major duodenal papilla inflammation is associated with lymphocytoplasmocytic (44.4%) and leucocytal infiltration (22.6%), dystrophic charges in glandular epithelium, gland hyperplasia (62.9%) (χ2(3) = 48.53; р &lt; 0.001; С = 0.75), demonstrating impact on bile passage. A higher risk of biliary sludge in gall bladder in patients with celiac syndrome is due to GB abnormalities and signs of inflammation and atrophy in major duodenal papilla mucosa and its relation to major duodenal papilla. Conclusion. Our analysis demonstrated that comorbidity in patients with celiac syndrome is associated with biliary dysfunction syndrome. Biliary dysfunction markers are congenital abnormalities in GB structure, that are a result of GB deformation and dyscholia; marked chronic inflammation of major duodenal papilla and duodenum mucosa; stage 3 atrophic changes in duodenum mucosa, according M.N. Marsh. Keywords: celiac syndrome, biliary dysfunction, gall bladder abnormalities, comorbid pathology.

Contemporary Perspective of Comorbidity in Celiac Syndrome: Connection Between Morphological Changes in Duodenum Mucosa and Biliary Dysfunction