Gluten-Free Diet Reduces Symptoms, Particularly Diarrhea, in Patients With Irritable Bowel Syndrome and Antigliadin IgG

Pinto-Sanchez, M I; Nardelli, Andrea; Borojevic, Rajka; Palma, Giada De; Calo, Natalia Causada; McCarville, Justin L.; Caminero, Alberto; Basra, Daniel; Mordhorst, Alexa; Ignatova, E; Hansen, Suzanne; Uhde, Melanie; Norman, Gary L.; Murray, Joseph A.; Smecuol, Edgardo; Armstrong, David; Bai, Julio C.; Schuppan, Detlef; Collins, Stephen M.; Alaedini, Armin; Martin, Paul; Berčík, Přemysl

doi:10.1016/j.cgh.2020.08.040

Cited by 41 publications

(56 citation statements)

References 30 publications

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“…Preliminary data suggest that response to a low FODMAP diet may be predicted from baseline faecal bacterial profile and metabolomic activity, while a gluten-free diet may benefit those with serum antigliadin antibodies. [213][214][215]…”

Section: Guidelinesmentioning

confidence: 99%

British Society of Gastroenterology guidelines on the management of irritable bowel syndrome

Vasant

Paine

Black

et al. 2021

Gut

290

334

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Irritable bowel syndrome (IBS) remains one of the most common gastrointestinal disorders seen by clinicians in both primary and secondary care. Since publication of the last British Society of Gastroenterology (BSG) guideline in 2007, substantial advances have been made in understanding its complex pathophysiology, resulting in its re-classification as a disorder of gut-brain interaction, rather than a functional gastrointestinal disorder. Moreover, there has been a considerable amount of new evidence published concerning the diagnosis, investigation and management of IBS. The primary aim of this guideline, commissioned by the BSG, is to review and summarise the current evidence to inform and guide clinical practice, by providing a practical framework for evidence-based management of patients. One of the strengths of this guideline is that the recommendations for treatment are based on evidence derived from a comprehensive search of the medical literature, which was used to inform an update of a series of trial-based and network meta-analyses assessing the efficacy of dietary, pharmacological and psychological therapies in treating IBS. Specific recommendations have been made according to the Grading of Recommendations Assessment, Development and Evaluation system, summarising both the strength of the recommendations and the overall quality of evidence. Finally, this guideline identifies novel treatments that are in development, as well as highlighting areas of unmet need for future research.

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Section: Guidelinesmentioning

confidence: 99%

British Society of Gastroenterology guidelines on the management of irritable bowel syndrome

Vasant

Paine

Black

et al. 2021

Gut

290

334

View full text Add to dashboard Cite

show abstract

“…Based on these results, the authors proposed this class of antibody as a biomarker to identify IBS patients in whom GFD might improve symptoms. Future studies involving a higher number of patients are needed to confirm these preliminary results [102].…”

Section: Ncgs Among Patients Diagnosed As Ibsmentioning

confidence: 86%

“…Anti-gliadin AGA-IgG antibodies [61] have been reported in higher prevalence in NCGS, although the corresponding data in the healthy population were not evaluated. A recent paper reported that 22% of IBS patients were AGA positive [102]. In a randomized DBPC gluten re-challenge trial in patients with IBS, a GCD was associated with higher small bowel permeability, as assessed with the lactulose/mannitol test.…”

Section: Ncgs Among Patients Diagnosed As Ibsmentioning

confidence: 98%

Non-Celiac Gluten Sensitivity in the Context of Functional Gastrointestinal Disorders

et al. 2020

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Gluten-free diets are increasingly chosen in the Western world, even in the absence of a diagnosis of celiac disease. Around 10% of people worldwide self-report gluten-related complaints, including intestinal and extra-intestinal symptoms. In most cases, these subjects would be labeled as patients suffering from irritable bowel syndrome (IBS) who place themselves on a gluten-free diet even in the absence of celiac disease. In some instances, patients report a clear benefit by avoiding gluten from their diet and/or symptom worsening upon gluten reintroduction. This clinical entity has been termed non-celiac gluten sensitivity (NCGS). The symptoms referred by these patients are both intestinal and extra-intestinal, suggesting that similarly to functional gastrointestinal disorders, NCGS is a disorder of gut–brain interaction. It remains unclear if gluten is the only wheat component involved in NCGS. The mechanisms underlying symptom generation in NCGS remain to be fully clarified, although in the past few years, the research has significantly moved forward with new data linking NCGS to changes in gut motility, permeability and innate immunity. The diagnosis is largely based on the self-reported reaction to gluten by the patient, as there are no available biomarkers, and confirmatory double-blind challenge protocols are unfeasible in daily clinical practice. Some studies suggest that a small proportion of patients with IBS have an intolerance to gluten. However, the benefits of gluten-free or low-gluten diets in non-celiac disease-related conditions are limited, and the long-term consequences of this practice may include nutritional and gut microbiota unbalance. Here, we summarize the role of gluten in the clinical features, pathophysiology, and management of NCGS and disorders of gut–brain interaction.

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“…Así mismo, si bien la dieta libre de gluten es esencial en el tratamiento de EC, incluso en el manejo de manifestaciones como la dermatitis herpetiforme y alteraciones psicológicas en estos pacientes, no hay suficientes evidencias para su utilización en otros padecimientos como la SGNC o el SII mismo 25 . A pesar de lo anterior, en un estudio en Canadá en pacientes con SII-Roma III, no seleccionados, aquellos que reportaron sensibilidad al gluten y que tenían antigliadinas IgA positivas respondieron en mayor proporción y de manera significativa a la dieta baja en gluten en comparación con los pacientes sin la presencia de antigliadinas IgA e IgG (75 vs. 38%) 26 . Además, una mayor proporción de pacientes con estos biomarcadores mejoraron el tránsito intestinal.…”

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“…Además, una mayor proporción de pacientes con estos biomarcadores mejoraron el tránsito intestinal. Más aún, la presencia de antigliadinas IgG fue un marcador predictor de la disminución de síntomas con la dieta libre de gluten en comparación con los pacientes sin este anticuerpo (RM: 128.9; IC 95%: 1.16-1,427.8; p = 0.04) 26 .…”

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Probióticos en dispepsia, microbiota y estreñimiento, gluten en el síndrome de intestino irritable y cannabinoides en trastornos motores y funcionales gastrointestinales

Schmulson-Wasserman¹,

Saps²

2022

NGL

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Gluten-Free Diet Reduces Symptoms, Particularly Diarrhea, in Patients With Irritable Bowel Syndrome and Antigliadin IgG

Cited by 41 publications

References 30 publications

British Society of Gastroenterology guidelines on the management of irritable bowel syndrome

British Society of Gastroenterology guidelines on the management of irritable bowel syndrome

Non-Celiac Gluten Sensitivity in the Context of Functional Gastrointestinal Disorders

Probióticos en dispepsia, microbiota y estreñimiento, gluten en el síndrome de intestino irritable y cannabinoides en trastornos motores y funcionales gastrointestinales

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