Symptomatic improvement with gluten restriction in irritable bowel syndrome: a prospective, randomized, double blinded placebo controlled trial

Vinay G Zanwar Sunil V Pawar; Sunil V Pawar; Pravir A Gambhire; Samit S Jain; Ravindra G Surude; Vinaya B Shah; Qais Q Contractor; Pravin M Rathi

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자료유형: 학술저널

저자정보: Vinay G Zanwar Sunil V Pawar (Topiwala National Medical College & Bai Yamunabai Laxman Nair Ch Hospital) Sunil V Pawar (Topiwala National Medical College & Bai Yamunabai Laxman Nair Ch Hospital) Pravir A Gambhire (Topiwala National Medical College & Bai Yamunabai Laxman Nair Ch Hospital) Samit S Jain (Topiwala National Medical College & Bai Yamunabai Laxman Nair Ch Hospital) Ravindra G Surude (Topiwala National Medical College & Bai Yamunabai Laxman Nair Ch Hospital) Vinaya B Shah (Topiwala National Medical College & Bai Yamunabai Laxman Nair Ch Hospital) Qais Q Contractor (Topiwala National Medical College & Bai Yamunabai Laxman Nair Ch Hospital) Pravin M Rathi (Topiwala National Medical College & Bai Yamunabai Laxman Nair Ch Hospital)

저널정보: 대한장연구학회 Intestinal research Intestinal research Vol.14 No.4

발행연도: 2016.1

수록면: 343 - 350 (8page)

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Background/Aims: The existence of non-celiac gluten sensitivity has been debated. Indeed, the intestinal and extra-intestinalsymptoms of many patients with irritable bowel syndrome (IBS) but without celiac disease or wheat allergy have been shownto improve on a gluten-free diet. Therefore, this study set out to evaluate the effects of gluten on IBS symptoms. Methods: Weperformed a double-blind randomized placebo-controlled rechallenge trial in a tertiary care hospital with IBS patients whofulfilled the Rome III criteria. Patients with celiac disease and wheat allergy were appropriately excluded. The participantswere administered a gluten-free diet for 4 weeks and were asked to complete a symptom-based questionnaire to assess theiroverall symptoms, abdominal pain, bloating, wind, and tiredness on the visual analog scale (0−100) at the baseline and everyweek thereafter. The participants who showed improvement were randomly assigned to one of two groups to receive either aplacebo (gluten-free breads) or gluten (whole cereal breads) as a rechallenge for the next 4 weeks. Results: In line with the protocolanalysis, 60 patients completed the study. The overall symptom score on the visual analog scale was significantly differentbetween the two groups (P <0.05). Moreover, the patients in the gluten intervention group scored significantly higher in termsof abdominal pain, bloating, and tiredness (P <0.05), and their symptoms worsened within 1 week of the rechallenge. Conclusions:A gluten diet may worsen the symptoms of IBS patients. Therefore, some form of gluten sensitivity other than celiac diseaseexists in some of them, and patients with IBS may benefit from gluten restrictions.

참고문헌 (31)

참고문헌 신청

Green PH / 2003 / Coeliac dise / Lancet 362:383~391

Elli L / 2015 / Diagnosis of gluten related disorders: celiac disease, wheat allergy and non-celiac gluten sensitivity / World J Gastroenterol 21:7110~7119

Drossman DA / 2002 / AGA technical review on irritable bowel syndrome / Gastroenterology 123:2108~2131

Catassi C / 2015 / Diagnosis of non-celiac gluten sensitivity (NCGS): the Salerno Experts’ Criteria / Nutrients 7:4966~4977

Cash BD / 2011 / The prevalence of celiac disease among patients with nonconstipated irritable bowel syndrome is similar to controls / Gastroenterology 141:1187~1193

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