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.


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.


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.


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.


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.


extraintestinal; gluten; intestinal; nonceliac gluten sensitivity; placebo

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