Non-Celiac Gluten Sensitivity Has Narrowed the Spectrum of Irritable Bowel Syndrome: A Double-Blind Randomized Placebo-Controlled Trial
by
Bijan Shahbazkhani 1,2,3, Amirsaeid Sadeghi 1,*, Reza Malekzadeh 2,3, Fatima Khatavi 4, Mehrnoosh Etemadi 4, Ebrahim Kalantri 5, Mohammad Rostami-Nejad 6 and Kamran Rostami 7
Bijan Shahbazkhani 1,2,3, Amirsaeid Sadeghi 1,*, Reza Malekzadeh 2,3, Fatima Khatavi 4, Mehrnoosh Etemadi 4, Ebrahim Kalantri 5, Mohammad Rostami-Nejad 6 and Kamran Rostami 7
1
Gastroenterology Unit, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran 5715915199, Iran
2
Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran 1599666615, Iran
3
Sasan Alborz Biomedical Research Center, Masoud Gastroenterology and Hepatology Clinic, Tehran 14117-13135, Iran
4
Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran 1449614535, Iran
5
Gholhak Medical Laboratory, Tehran 1913913948, Iran
6
Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran 1985714711, Iran
7
Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, UK
*
Author to whom correspondence should be addressed.
Nutrients 2015, 7(6), 4542-4554; https://doi.org/10.3390/nu7064542
Received: 2 February 2015 / Revised: 21 May 2015 / Accepted: 26 May 2015 / Published: 5 June 2015
(This article belongs to the Special Issue Gluten Related Disorders: People Shall not Live on Bread Alone)
Several studies have shown that a large number of patients who are fulfilling the criteria for irritable bowel syndrome (IBS) are sensitive to gluten. The aim of this study was to evaluate the effect of a gluten-free diet on gastrointestinal symptoms in patients with IBS. In this double-blind randomized, placebo-controlled trial, 148 IBS patients fulfilling the Rome III criteria were enrolled between 2011 and 2013. However, only 72 out of the 148 commenced on a gluten-free diet for up to six weeks and completed the study; clinical symptoms were recorded biweekly using a standard visual analogue scale (VAS). In the second stage after six weeks, patients whose symptoms improved to an acceptable level were randomly divided into two groups; patients either received packages containing powdered gluten (35 cases) or patients received placebo (gluten free powder) (37 cases). Overall, the symptomatic improvement was statistically different in the gluten-containing group compared with placebo group in 9 (25.7%), and 31 (83.8%) patients respectively (p < 0.001). A large number of patients labelled as irritable bowel syndrome are sensitive to gluten. Using the term of IBS can therefore be misleading and may deviate and postpone the application of an effective and well-targeted treatment strategy in gluten sensitive patients.
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Keywords:
IBS; non-celiac gluten sensitivity; gluten free diet
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MDPI and ACS Style
Shahbazkhani, B.; Sadeghi, A.; Malekzadeh, R.; Khatavi, F.; Etemadi, M.; Kalantri, E.; Rostami-Nejad, M.; Rostami, K. Non-Celiac Gluten Sensitivity Has Narrowed the Spectrum of Irritable Bowel Syndrome: A Double-Blind Randomized Placebo-Controlled Trial. Nutrients 2015, 7, 4542-4554.
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