Symptoms of Functional Intestinal Disorders Are Common in Patients with Celiac Disease Following Transition to a Gluten-Free Diet.

Abstract

BACKGROUND:

Celiac disease and functional intestinal disorders may overlap, yet the natural history of functional symptoms in patients with celiac disease is unknown.

AIM:

To investigate the prevalence of irritable bowel syndrome (IBS), functional dyspepsia (FD), and functional bloating (FB) symptoms among patients with celiac disease at diagnosis and during the first year of a gluten-free diet.

METHODS:

Adults with a new diagnosis of celiac disease were surveyed at baseline, 6 months and 1 year using standardized measures for intestinal symptoms [Rome III diagnostic questionnaire and celiac symptom index (CSI)] and gluten-free diet adherence [gluten-free eating assessment tool (GF-EAT) and celiac diet adherence test].

RESULTS:

At diagnosis, two-thirds fulfilled Rome III diagnostic questionnaire symptom criteria for IBS (52%), functional dyspepsia (27%), and/or functional bloating (9%). One year post-diagnosis, there was high adherence to a gluten-free diet as 93% reported gluten exposure less than once per month on the GF-EAT and only 8% had ongoing celiac disease symptoms (CSI score >45). The rates of those meeting IBS (22%) and functional dyspepsia (8%) symptom criteria both decreased significantly on a gluten-free diet. The prevalence of functional symptoms (any of IBS, FD or FB) at 1 year was 47%.

CONCLUSIONS:

Long-term follow-up of patients with celiac disease is necessary because many patients with celiac disease who are adherent to a gluten-free diet have persistent gastrointestinal symptoms.

• Authors: Jocelyn A Silvester, Lesley A Graff, Lisa Rigaux, Charles N Bernstein, Daniel A Leffler, Ciarán P Kelly, John R Walker, Donald R Duerksen
• Journal: Digestive diseases and sciences (Dig Dis Sci) Vol. 62 Issue 9 Pg. 2449-2454 (09 2017) ISSN: 1573-2568 [Electronic] United States
• PMID: 28687943 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, N.I.H., Extramural)

Topics

• Adult
• Celiac Disease (diagnosis, diet therapy, epidemiology)
• Cohort Studies
• Diet, Gluten-Free (adverse effects, trends)
• Dyspepsia (diagnosis, diet therapy, epidemiology)
• Female
• Humans
• Irritable Bowel Syndrome (diagnosis, diet therapy, epidemiology)
• Male
• Middle Aged
• Prospective Studies
• Surveys and Questionnaires