Irritable Bowel Syndrome and Gluten-Related Disorders.

Paolo Usai-Satta,Massimo Bellini,Francesco Cabras,Francesco Oppia,Mariantonia Lai,Gabrio Bassotti

doi:10.3390/nu12041117

Paolo Usai-Satta, Massimo Bellini + Show 4 more

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https://doi.org/10.3390/nu12041117

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Abstract

Background: Irritable bowel syndrome (IBS) is frequently associated with celiac disease (CD) and nonceliac gluten/wheat sensitivity (NCGS/NCWS), but epidemiological and pathophysiological aspects are still unclear. Furthermore, a gluten-free diet (GFD) can positively influence IBS symptoms. Methods: A comprehensive online search for IBS related to CD, NCGS and GFD was made using the Pubmed, Medline and Cochrane databases. Results: Although a systematic screening for CD in IBS is not recommended, CD prevalence can be increased in diarrhea-predominant IBS patients. On the other hand, IBS symptoms can be persistent in treated CD patients, and their prevalence tends to decrease on a GFD. IBS symptoms may overlap and be similar to those associated to nonceliac gluten and/or wheat sensitivity. Increased gut permeability could explain the gluten/wheat effects in IBS patients. Finally, a GFD could improve symptoms in a subgroup of IBS patients. Conclusions: The possible interplay between IBS and gluten-related disorders represents a scientifically and clinically challenging issue. Further studies are needed to confirm these data and better clarify the involved pathophysiological mechanisms.

Highlights

Irritable bowel syndrome (IBS) is the most frequently diagnosed functional gastrointestinal disorder, causing abdominal pain, bloating, diarrhea and constipation [1]
The mutual interplay between IBS and gluten-related disorders represents a topic of increasing interest
The prevalence of celiac disease (CD) may be increased in IBS-D patients, universal screening for CD

Summary

Introduction

Irritable bowel syndrome (IBS) is the most frequently diagnosed functional gastrointestinal disorder, causing abdominal pain, bloating, diarrhea and constipation [1]. Since there are no available biological markers that clearly identify such patients, the diagnosis of IBS is usually made based on the symptoms according to the Rome IV criteria [7]. These criteria suggest performing limited laboratory studies, including serological tests for celiac disease (CD) in patients with IBS-D and IBS-M. A gluten-free diet (GFD) can positively influence IBS symptoms

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