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Dig Dis Sci. 2017 Sep;62(9):2449-2454. doi: 10.1007/s10620-017-4666-z. Epub 2017 Jul 7.

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

Author information

1
Rady College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
2
Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
3
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
4
St. Boniface Hospital Research Center, Winnipeg, MB, USA.
5
Rady College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada. donald.duerksen@umanitoba.ca.
6
St. Boniface Hospital Research Center, Winnipeg, MB, USA. donald.duerksen@umanitoba.ca.
7
Division of Gastroenterology, C5-120 St Boniface Hospital, 409 Tache Avenue, Winnipeg, MB, R2H 2A6, USA. donald.duerksen@umanitoba.ca.

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.

KEYWORDS:

Celiac disease; Functional bloating; Functional dyspepsia; Gluten-free diet; Irritable bowel syndrome; Prospective cohort study

PMID:
28687943
PMCID:
PMC5738027
DOI:
10.1007/s10620-017-4666-z
[Indexed for MEDLINE]
Free PMC Article

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