Abstract
BackgroundCeliac disease (CD) is an autoimmune disorder, characterized by the presence of gastrointestinal and multisystem symptoms, which occasionally mimic those of Irritable Bowel Syndrome (IBS) and Fibromyalgia Syndrome (FMS). To assess the effectiveness of a Gluten-Free Diet (GFD) in seven adult female screening-detected CD subjects, categorized as severe IBS and FMS patients.MethodsAll subjects showed villous atrophy in duodenal biopsies, were HLA-DQ2/DQ8-positive, and fulfilled the Rome III and ACR 1990 criteria respectively for IBS and FMS classification. GFD effectiveness was assessed at baseline and after 1 year, examining the score changes in the Tender Points (TPs) test, Fibromyalgia Impact Questionnaire (FIQ), Health Assessment Questionnaire (HAQ), Short Form Health Survey (SF-36), Visual Analogue Scales (VAS) for gastrointestinal complaints, pain and tiredness, drug prescriptions and tissue-Trans-Glutaminase (tTG) serum levels.ResultsAt baseline, all patients had poor Quality of Life and VAS scores, a high number of TPs and drug prescriptions, and increased tTG levels. After 1 year of GFD, all outcome measures significantly improved, with a decrease of 51-60% in TPs, FIQ, HAQ, and VAS scales, and in the number of prescribed drugs, accompanied by an increase of 48-60% in SF-36 Physical and Mental Component Summary scores, and a decrease of tTG to normal values.ConclusionResults of this pilot study show that the adherence to a GFD by CD-related IBS/FMS patients can simultaneously improve CD and IBS/FMS symptoms, and indicate the merit of further research on a larger cohort.
Highlights
Celiac disease (CD) is an autoimmune disorder, characterized by the presence of gastrointestinal and multisystem symptoms, which occasionally mimic those of Irritable Bowel Syndrome (IBS) and Fibromyalgia Syndrome (FMS)
Diagnosis of IBS is based on a positive history of gastrointestinal symptoms (Rome III criteria) in the absence of alarm features, such as: age of onset >50 years, weight loss, rectal bleeding, iron-deficient anemia, systemic
Study population and data source During the 6-year period 2007–2012, we prospectively studied a total of 442 consecutive patients, applying the Rome III criteria for IBS [3] and the American College of Rheumatology (ACR) 1990 criteria for FMS [6] upon their first visit to the Gastroenterology Outpatient Clinic at the Central University Hospital of Asturias, HUCA (Oviedo, Spain)
Summary
Celiac disease (CD) is an autoimmune disorder, characterized by the presence of gastrointestinal and multisystem symptoms, which occasionally mimic those of Irritable Bowel Syndrome (IBS) and Fibromyalgia Syndrome (FMS). Until about two or three decades ago, Celiac Disease (CD) was considered to be a rare disease, but has proved to be very common, with a fairly uniform worldwide distribution and an average prevalence of 1-2%. It is underdiagnosed, leading to its prevalence being underestimated. The disease can be associated with and/or mimicked by many other intestinal and extra-intestinal diseases [10]
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