Jocelyn A Silvester1,2,3, Lesley A Graff1, Lisa Rigaux4, Charles N Bernstein1, Daniel A Leffler3, Ciarán P Kelly3, John R Walker1, Donald R Duerksen5,6,7. 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.
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: Daniel A Leffler; Melinda Dennis; Jessica Edwards George; Shailaja Jamma; E Francis Cook; Detlef Schuppan; Ciaran P Kelly Journal: Clin Gastroenterol Hepatol Date: 2009-08-07 Impact factor: 11.382
Authors: Muhammad Ali Khan; Salman Nusrat; Muhammad Imran Khan; Ali Nawras; Klaus Bielefeldt Journal: Dig Dis Sci Date: 2014-11-20 Impact factor: 3.199
Authors: Isabel Comino; Fernando Fernández-Bañares; María Esteve; Luís Ortigosa; Gemma Castillejo; Blanca Fambuena; Carmen Ribes-Koninckx; Carlos Sierra; Alfonso Rodríguez-Herrera; José Carlos Salazar; Ángel Caunedo; J M Marugán-Miguelsanz; José Antonio Garrote; Santiago Vivas; Oreste Lo Iacono; Alejandro Nuñez; Luis Vaquero; Ana María Vegas; Laura Crespo; Luis Fernández-Salazar; Eduardo Arranz; Victoria Alejandra Jiménez-García; Marco Antonio Montes-Cano; Beatriz Espín; Ana Galera; Justo Valverde; Francisco José Girón; Miguel Bolonio; Antonio Millán; Francesc Martínez Cerezo; César Guajardo; José Ramón Alberto; Mercé Rosinach; Verónica Segura; Francisco León; Jorge Marinich; Alba Muñoz-Suano; Manuel Romero-Gómez; Ángel Cebolla; Carolina Sousa Journal: Am J Gastroenterol Date: 2016-09-20 Impact factor: 10.864
Authors: Noémi Zádori; Dávid Németh; Levente Frim; Nóra Vörhendi; Lajos Szakó; Szilárd Váncsa; Péter Hegyi; József Czimmer Journal: Int J Gen Med Date: 2022-10-12
Authors: Line Lund Kårhus; Betina H Thuesen; Tea Skaaby; Jüri J Rumessen; Allan Linneberg Journal: United European Gastroenterol J Date: 2018-03-08 Impact factor: 4.623