Self-reported Wheat Sensitivity in Irritable Bowel Syndrome and Healthy Subjects: Prevalence of Celiac Markers and Response to Wheat-free Diet

Pavan Dhoble; Philip Abraham; Devendra Desai; Anand Joshi; Tarun Gupta; Shachish Doctor; Anand Deshpande; Rajeshwari Basavanna

doi:10.5056/jnm20086

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저자정보: Pavan Dhoble (Division of Gastroenterology P D Hinduja Hospital Mumbai India) Philip Abraham (Division of Gastroenterology P D Hinduja Hospital Mumbai India) Devendra Desai (Division of Gastroenterology P D Hinduja Hospital Mumbai India) Anand Joshi (Division of Gastroenterology P D Hinduja Hospital Mumbai India) Tarun Gupta (Division of Gastroenterology P D Hinduja Hospital Mumbai India) Shachish Doctor (Division of Gastroenterology P D Hinduja Hospital Mumbai India) Anand Deshpande (Department of Transfusion Medicine P D Hinjuja Hospital Mumbai India) Rajeshwari Basavanna (Department of Transfusion Medicine P D Hinjuja Hospital Mumbai India)

저널정보: 대한소화관운동학회(현 대한소화기능성질환.운동학회) Journal of Neurogastroenterology and Motility (JNM) Journal of Neurogastroenterology and Motility (JNM) Vol.27 No.4

발행연도: 2021.10

수록면: 596 - 601 (6page)

DOI: 10.5056/jnm20086

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Background/AimsMost patients with irritable bowel syndrome (IBS) report food-related aggravation of symptoms. Wheat/gluten is one of the most commonly incriminated. We studied the prevalence of self-reported wheat sensitivity in patients with IBS and in a healthy population from a region in India consuming mixed-cereal diets, correlated it with serological and human leukocyte antigen (HLA) markers of celiac disease, and evaluated the response to a wheat-free diet. MethodsWe surveyed 204 patients with IBS and 400 healthy persons for self-reported wheat sensitivity. Testing for IgA anti-tissue transglutaminase and HLA DQ2 or DQ8 was done in individuals who reported wheat sensitivity. Consenting persons with wheat sensitivity were put on wheat-free diet and monitored for symptom change. ResultsTwenty-three of 204 patients with IBS (11.3%) and none of the healthy subjects self-reported wheat sensitivity. Of 23 patients, 14 (60.9%) were positive for HLA DQ2 or DQ8 and none for anti-tissue transglutaminase antibody. After 6 weeks on wheat-free diet, all 19 participating patients reported clinical improvement; fewer patients had bloating, diarrhea, constipation, and easy fatigue. ConclusionsEleven percent of patients with IBS self-reported wheat sensitivity. None of them had positive celiac serology; 60.9% were positive for HLA DQ2 and DQ8, suggesting a possible genetic basis. All of them improved symptomatically on a wheat-free diet.

#Food sensitivity #Gluten sensitivity #HLA typing #Non-celiac gluten sensitivity #Transglutaminases

참고문헌 (29)

참고문헌 신청

Zar S / 2001 / Food hypersensitivity and irritable bowel syndrome / Aliment Pharmacol Ther 15:439~449

Böhn L / 2013 / Selfreported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life / Am J Gastroenterol 108:634~641

Sharma H / 2015 / Prevalence of celiac disease in Indian patients with irritable bowel syndrome and uninvestigated dyspepsia / J Dig Dis 16:443~448

Sapone A / 2012 / Spectrum of gluten-related disorders : consensus on new nomenclature and classification / BMC Med 10:13

Wang H / 2015 / Serological screening for celiac disease in adult Chinese patients with diarrhea predominant irritable bowel syndrome / Medicine 94:e1779

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