A gluten-free diet for endometriosis patients lacks evidence to recommend it.

Autor:	van Haaps AP; Department of Reproductive Medicine and Endometriosis Center, Amsterdam University Medical Center, Amsterdam, The Netherlands (van Haaps, Schreurs, and Mijatovic).; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands (van Haaps, Schreurs, and Mijatovic)., Brouns F; Department of Human Biology, School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands (Brouns)., Schreurs AMF; Department of Reproductive Medicine and Endometriosis Center, Amsterdam University Medical Center, Amsterdam, The Netherlands (van Haaps, Schreurs, and Mijatovic).; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands (van Haaps, Schreurs, and Mijatovic)., Keszthelyi D; Department of Gastroenterology and Hepatology, Nutrition and Translational Research in Metabolism Research Institute, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands (Keszthelyi)., Maas JWM; GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands (Maas).; Department of Obstetrics and Gynaecology, Maastricht University Medical Center, Maastricht, The Netherlands (Maas)., Mijatovic V; Department of Reproductive Medicine and Endometriosis Center, Amsterdam University Medical Center, Amsterdam, The Netherlands (van Haaps, Schreurs, and Mijatovic).; Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands (van Haaps, Schreurs, and Mijatovic).
Jazyk:	angličtina
Zdroj:	AJOG global reports [AJOG Glob Rep] 2024 Jun 18; Vol. 4 (3), pp. 100369. Date of Electronic Publication: 2024 Jun 18 (Print Publication: 2024).
DOI:	10.1016/j.xagr.2024.100369
Abstrakt:	Endometriosis is an estrogen-dependent chronic disease characterized by the presence of endometriumlike tissue outside the uterus and is often associated with symptoms, such as dysmenorrhea, dysuria, dyschezia, chronic pelvic pain, and infertility. Moreover, women diagnosed with endometriosis can report gastrointestinal symptoms, including bloating, constipation or diarrhea, and abdominal cramping, which can be associated with irritable bowel syndrome and can result in the misdiagnosis of endometriosis as irritable bowel syndrome at first. Treatment usually involves hormonal therapy, pain management, surgery, and/or assisted reproductive techniques in case of infertility. Nonetheless, these treatment methods can be insufficient for alleviating symptoms or can have unacceptable side effects, leading to noncompliance. Therefore, women often apply self-management strategies, including dietary interventions. One of the diets frequently suggested as a tool to manage endometriosis-related symptoms on social media and patient forums is a gluten-free diet. Although a gluten-free diet has been proven effective in managing nonceliac wheat sensitivity or celiac disease, its effectiveness in endometriosis remains uncertain. The Nurses' Health Study II found it unlikely that gluten intake was a strong factor in endometriosis etiology and symptomatology. To the best of our knowledge, the most frequently cited and sole published intervention study on the efficacy of a gluten-free diet for endometriosis has several important limiting factors, including the absence of a control group. In addition, gluten consumption is highly susceptible to a placebo effect and a nocebo effect, where women might experience symptom relief after eliminating gluten and return of symptoms after they consume gluten again, solely because they believe that gluten is bad for them. Despite the inverse association between body mass index and endometriosis and between a gluten-free diet and increased body mass index, this is an association, and no causality was proven. In addition, other factors should be taken into consideration. Of note, a gluten-free diet is expensive, has limited availability, and has a significant effect on quality of life. Moreover, without proper dietary guidance, it may adversely affect the gastrointestinal microbiome. Therefore, scientifically substantiated advice regarding the use of a gluten-free diet for endometriosis-related symptoms is currently not available, and a gluten-free diet should be discouraged unless there is an additional diagnosis of nonceliac wheat sensitivity or celiac disease. (© 2024 The Authors.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu