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Gastroenterol Hepatol (N Y). 2013 Feb;9(2):85-91.

What role does wheat play in the symptoms of irritable bowel syndrome?

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Dr. Eswaran is a Clinical Lecturer at the University of Michigan Health System in Ann Arbor, Michigan. Dr. Goel is a Resident Physician in the Department of Internal Medicine at New York-Presbyterian Hospital, Columbia University in New York, New York. Dr. Chey is a Professor of Medicine, Director of the GI Physiology Laboratory, Co-Director of the Michigan Bowel Control Program, and H. Marvin Pollard Institute Scholar, all at the University of Michigan Health System in Ann Arbor, Michigan.


Recently, increasing attention has been paid to the pathologic role of food in irritable bowel syndrome (IBS). Nevertheless, healthcare providers often avoid addressing diet with their patients because of a lack of training, guideline consensus, and high-quality data. Recent literature supports the existence of a subgroup of IBS patients with undiagnosed nonceliac gluten sensitivity (NCGS), a term that is used to describe individuals who experience gastrointestinal and extraintestinal symptoms as a result of immunologic, morphologic, or symptomatic abnormalities that are precipitated by the ingestion of gluten. NCGS represents an important subgroup of patients with IBS who are highly treatable via dietary modification. Gluten may influence gastrointestinal symptoms through immune activation or alteration of intestinal permeability, but the true role of food in functional gastrointestinal symptomatology remains unclear. For example, gluten is just 1 component of the complex milieu of nutrients found in wheat and related grains, and NCGS likely represents only the tip of the iceberg as it pertains to the role of food in IBS.


Celiac disease; food; gluten sensitivity; irritable bowel syndrome; wheat intolerance


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