Irritable Bowel Syndrome (IBS) and gluten

Irritable Bowel Syndrome (IBS) is a common adult condition, with bowel disturbance, bloating and abdominal pain.  Gluten is often a proving agent. Data from a 2007 medical paper, by Ulrich Wahnschaffe, that shows people with Irritable Bowel Syndrome (IBS), especially with diarrhoea, are often gluten-sensitive. Testing for IgG-gliadin antibody will diagnose these people. Yet more evidence that gluten sensitivity is very wide spread, and under diagnosed. Read the full abstract below:

Irritable Bowel Syndrome (IBS) and gluten

Predictors of Clinical Response to Gluten-Free Diet in Patients Diagnosed With – Diarrhea- Predominant Irritable Bowel Syndrome

Ulrich Wahnschaffe, Jorg-Dieter Schulzke, Martin Zeitz, Reiner Ullrich. Clinical Gastroenterology and Hepatology-Volume 5Issue 7, Pages 844-850, 2007.

Background & Aims: Gluten sensitivity might cause abdominal symptoms in the absence of villous atrophy. We examined the prevalence of celiac disease – associated serum antibodies in diarrhea-dominant irritable bowel syndrome (d-IBS) patients and their efficacy in combination with HLA-DQ2 expression to predict the response to gluten-free diet.

Methods: HLA-DQA1*0501/DQB1*0201 expression and celiac disease-associated IgA and IgG serum antibodies against gliadin and tissue-transglutaminase were measured in 145 patients with d-IBS, 74 patients with untreated and treated celiac disease, and 57 patients with active IBD. Follow-up antibody levels, stool frequency, and gastrointestinal symptom scores were determined in 41 d-IBS patients (26 women, 15 men; median age, 46 years, range, 30-67 years) who participated in a nonrandomized evaluation of 6 months of gluten-free diet.

Results: Increased celiac disease-associated serum IgG, but not IgA, was found in the majority of patients with treated (55%) as in most patients with untreated celiac disease (97%). In d-IBS patients, celiac disease-associated serum IgG antibodies (37%) and HLA-DQ2 expression (39%) were more frequent than in IBD patients (18% and 23%, respectively). After 6 months of gluten-free diet, stool frequency and gastrointestinal symptom score returned to normal values in 60% of d-IBS patients who were positive and in 12% who were negative for HLA-DQ2 and celiac disease-associated serum IgG; both parameters combined yielded positive and negative predictive values of 56% (95% confidence interval, 30%?80%) and 88% (69%?97%), respectively.

Conclusions: Celiac disease-associated serum IgG and HLA-DQ2 expression can identify likely responders to gluten-free diet in d-IBS patients.


 

A more recent article confirms gluten-sensitivity.  Here is the research Abstract.

Clin Gastroenterol Hepatol. 2015 Feb 19. pii: S1542-3565(15)00153-6. doi: 10.1016/j.cgh.2015.01.029. [Epub ahead of print]

Small Amounts of Gluten in Subjects with Suspected Nonceliac Gluten Sensitivity: a Randomized, Double-Blind, Placebo-Controlled, Cross-Over Trial.

by Di Sabatino, Volta, Salvatore, Biancheri, Caio, De Giorgio, Di Stefano, Corazza.

BACKGROUND & AIMS:

There is debate over the existence of nonceliac gluten sensitivity (NCGS) -intestinal and extra-intestinal symptoms in response to ingestion of gluten-containing foods by people without celiac disease or wheat allergy. We performed a randomized, double-blind, placebo-controlled, cross-over trial to determine the effects of administration of low doses of gluten to subjects with suspected NCGS.

METHODS:

We enrolled 61 adults without celiac disease or wheat allergy who believe ingestion of gluten-containing food to be the cause of their intestinal and extra-intestinal symptoms. Participants were randomly assigned to groups given either 4.375 g/day gluten or rice starch (placebo) for 1 week, each via gastro-soluble capsules. After a 1 week of gluten-free diet, participants crossed over to the other group. The primary outcome was the change in overall (intestinal and extra-intestinal) symptoms, determined by established scoring systems, between gluten and placebo intake. A secondary outcome was the change in individual symptom scores between gluten vs placebo.

RESULTS:

According to the per-protocol analysis of data from the 59 patients who completed the trial, intake of gluten significantly increased overall symptoms compared with placebo (P=.034). Abdominal bloating (P=.040) and pain (P=.047), among the intestinal symptoms, and foggy mind (P=.019), depression (P=.020), and aphthous stomatitis (P=.025), among the extra-intestinal symptoms, were significantly more severe when subjects received gluten than placebo.

CONCLUSIONS:

In a cross-over trial of subjects with suspected NCGS, the severity of overall symptoms increased significantly during 1 week of intake of small amounts of gluten, compared with placebo. Clinical trial no: ISRCTN72857280.

Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

extraintestinal; gluten; intestinal; nonceliac gluten sensitivity; placebo


There is no doubt that gluten cases a lot of illness and harm.