Evaluation of Non-Celiac Gluten Sensitivity in Patients with Previous Diagnosis of Irritable Bowel Syndrome: A Randomized Double-Blind Placebo-Controlled Crossover Trial
| Autor: | Ruggiero Francavilla, Eugenio Gemello, Andrea Iannone, Fernanda Cristofori, Maria Teresa Viggiani, Caterina Renna, Michele Barone, Alfredo Di Leo |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Glutens Visual analogue scale Polymers Oligosaccharides lcsh:TX341-641 FODMAP Placebo Disaccharides Gastroenterology Article gluten challenge Double blind Irritable Bowel Syndrome 03 medical and health sciences Diet Gluten-Free 0302 clinical medicine Double-Blind Method gluten-free diet Internal medicine Dietary Carbohydrates Medicine Humans 030212 general & internal medicine Irritable bowel syndrome chemistry.chemical_classification Nutrition and Dietetics business.industry Monosaccharides Middle Aged medicine.disease Gluten Crossover study chemistry Fermentation 030211 gastroenterology & hepatology Female business lcsh:Nutrition. Foods and food supply Body mass index Food Hypersensitivity Food Science |
| Zdroj: | Nutrients Volume 12 Issue 3 Nutrients, Vol 12, Iss 3, p 705 (2020) |
| ISSN: | 2072-6643 |
| DOI: | 10.3390/nu12030705 |
| Popis: | Background. To date, there is no reliable marker for the diagnosis of non-celiac gluten sensitivity (NCGS), which benefits from a gluten-free diet (GFD). This condition is characterized by functional gastrointestinal symptoms similar to those occurring in the course of irritable bowel syndrome (IBS). However, IBS has a higher prevalence, and often benefits from the administration of a low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet. The overlap of symptoms between these two pathologies has led to an overestimation of self-made diagnosis NCGS. Aims. To better identify NCGS in subjects with a previous diagnosis of IBS. Methods. All subjects received a low FODMAP diet that was also gluten-free (low FODMAP-GFD), and those presenting an improvement of symptoms were exposed to gluten or placebo (double-blind challenge with wash-out and crossover). The response to dietary treatments was evaluated by visual analogue scale (VAS). Results. Of 30 patients (23 women, seven men, aged 42.2 ± 12.5 years, body mass index (BMI ) 24.7 ± 4.1 kg/m2), 26 benefited from the administration of low FODMAP-GFD and were exposed to the gluten/placebo challenge. After the challenge, using an increase of visual analogue scale VAS (&Delta VAS) &ge 30%, 46.1% of the patients were NCGS+. However, this percentage became only 19.2% using a different method (mean ∆-VAS score plus two standard deviations). Conclusions. FODMAP intolerance could hide the response to a challenge test with gluten for the identification of NCGS in IBS patients. A low FODMAP-GFD followed by gluten/placebo challenge is able to identify patients with NCGS better. ClinicalTrials.gov registration number NCT04017585. |
| Databáze: | OpenAIRE |
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