Functional gastrointestinal disorders and coeliac disease in adults - negative impact on quality of life

Abstract

Sirs, We read with interest the article by Turco et al.1 The authors are the first to demonstrate within a paediatric population, a significantly higher prevalence of functional gastrointestinal disorders (FGIDs) in patients with coeliac disease adhering to a gluten-free diet compared to age-matched controls. We would like to provide a further novel insight into another important aspect of the relationship between FGIDs and coeliac disease. We recently undertook a cross-sectional survey using the short-form 36-Item Health Survey (SF-36) to evaluate quality of life in adult patients with coeliac disease and in controls.2 We also used the ROME II Criteria and the Hospital Anxiety and Depression Scale (HADS) to evaluate the prevalence of irritable bowel syndrome (IBS) within these two groups, with the aim of determining the impact, this may have on quality of life and psychological well-being. Two hundred and twenty-five patients (25% male, mean age 53 years) with adult coeliac disease and 348 age- and sex-matched controls were enrolled into the study. The prevalence of IBS within the cohort of coeliac patients was 22% and 6% within the control group. The presence of concomitant IBS was identified as an independent risk factor that reduced the quality of life in patients with coeliac disease (P ≤ 0.0001). Although Turco et al. are correct to suggest that we do not as yet understand the mechanisms of why FGIDs are seen in the context of coeliac disease, nevertheless asking adult coeliac patients about the presence of IBS-type symptoms may allow an opportunity for an intervention that could potentially have a positive impact on their quality of life. Declaration of personal and funding interests: None.