scholarly journals Gluten-Associated Pathology: Focusing on Patients with Irritable Bowel Syndrome

2020 ◽  
Vol 16 (30) ◽  
pp. 66-73
Author(s):  
O.V. Gaus ◽  
◽  
M.A. Livzan ◽  
D.V. Popello
Keyword(s):  
Irritable Bowel Syndrome ◽  
Celiac Disease ◽  
Clinical Symptoms ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Wheat Allergy ◽  
The World ◽  
Wheat Products ◽  
Irritable Bowel ◽  
The Many

Wheat is an essential part of the diet of many people around the world. Despite the many beneficial aspects of eating wheat products, they can be associated with the development of a variety of diseases. The spectrum of gluten-associated pathologies includes celiac disease, wheat allergy, and non-celiac gluten sensitivity (NCGS). The clinical symptoms of gluten-associated pathology are similar to those of irritable bowel syndrome (IBS). Diagnosis of celiac disease and wheat allergy is now straightforward. NCGS remains a diagnosis of exclusion due to the lack of specific biomarkers and standardized research methods. Many patients with IBS consider themselves gluten-sensitive and their symptoms are relieved by a gluten-free diet. Most likely it is NCGS that occurs in a heterogeneous group of patients with IBS. However it remains controversial whether the development of symptoms in this case is associated with gluten itself or with other components of wheat, such as non-gluten proteins and FODMAPs.

scholarly journals The Role of a Low Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyol Diet in Nonceliac Gluten Sensitivity

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
P. Priyanka ◽  
S. Gayam ◽  
J. T. Kupec
Keyword(s):  
Systematic Review ◽  
Celiac Disease ◽  
Wheat Germ ◽  
Clinical Symptoms ◽  
Additional Benefit ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Wheat Allergy ◽  
Fodmap Diet

Background. Nonceliac gluten sensitivity (NCGS) is a recently defined clinical entity characterized by intestinal and extraintestinal symptoms associated with gluten ingestion in individuals in whom celiac disease (CD) or wheat allergy (WA) has been excluded. Despite its name and definition, gluten has been shown to precipitate symptoms in only 16–30% of these patients. In addition to gluten, other components of wheat, including fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs), alpha-amylase trypsin inhibitors (ATIs) and wheat germ agglutinin have been implicated in the causation of the symptoms of NCGS, with FODMAPs garnering the most attention. We present a review of the existing literature evaluating the role of FODMAPs in NCGS symptomatology. Methods. A systematic review of PubMed, Cochrane, EMBASE, and Google Scholar for keywords fructans, non-celiac gluten sensitivity, NCGS, FODMAPs, and gluten-free diet (GFD) was conducted through a series of advanced searches. Articles related to the use of fructans or FODMAPs were analyzed. Results. FODMAPs were found to be associated with gastrointestinal and extraintestinal symptoms in NCGS. Conclusions. A low FODMAP diet has potential for improvement of clinical symptoms in NCGS. In addition, some evidence suggests an additional benefit to simultaneous adherence to both low FODMAP diet and GFD.

scholarly journals Non-Celiac Gluten Sensitivity: A Review

Medicina ◽  
2019 ◽  
Vol 55 (6) ◽  
pp. 222 ◽  
Author(s):  
Anna Roszkowska ◽  
Marta Pawlicka ◽  
Anna Mroczek ◽  
Kamil Bałabuszek ◽  
Barbara Nieradko-Iwanicka
Keyword(s):  
Clinical Trials ◽  
Irritable Bowel Syndrome ◽  
Wheat Gluten ◽  
Abdominal Discomfort ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Wheat Allergy ◽  
Nutritional Treatment ◽  
Irritable Bowel ◽  
Specific Symptoms

Background and objectives: Grain food consumption is a trigger of gluten related disorders: celiac disease, non-celiac gluten sensitivity (NCGS) and wheat allergy. They demonstrate with non-specific symptoms: bloating, abdominal discomfort, diarrhea and flatulence. Aim: The aim of the review is to summarize data about pathogenesis, symptoms and criteria of NCGS, which can be helpful for physicians. Materials and Methods: The PubMed and Google Scholar databases were searched in January 2019 with phrases: ’non-celiac gluten sensitivity’, non-celiac gluten sensitivity’, non-celiac wheat gluten sensitivity’, non-celiac wheat gluten sensitivity’, and gluten sensitivity’. More than 1000 results were found. A total of 67 clinical trials published between 1989 and 2019 was scanned. After skimming abstracts, 66 articles were chosen for this review; including 26 clinical trials. Results: In 2015, Salerno Experts’ Criteria of NCGS were published. The Salerno first step is assessing the clinical response to gluten free diet (GFD) and second is measuring the effect of reintroducing gluten after a period of treatment with GFD. Several clinical trials were based on the criteria. Conclusions: Symptoms of NCGS are similar to other gluten-related diseases, irritable bowel syndrome and Crohn’s disease. With Salerno Experts’ Criteria of NCGS, it is possible to diagnose patients properly and give them advice about nutritional treatment.

scholarly journals IRRITABLE BOWEL SYNDROME, FOOD INTOLERANCE AND NON- CELIAC GLUTEN SENSITIVITY. A NEW CLINICAL CHALLENGE

2018 ◽  
Vol 55 (4) ◽  
pp. 417-422 ◽  
Author(s):  
Rosa Leonôra Salerno SOARES
Keyword(s):  
Irritable Bowel Syndrome ◽  
Celiac Disease ◽  
Food Intolerance ◽  
Gluten Sensitivity ◽  
Wheat Allergy ◽  
Food Groups ◽  
Irritable Bowel ◽  
Clinical Conditions ◽  
Related Proteins

ABSTRACT Approximately 80% of irritable bowel syndrome (IBS) patients report that their symptoms are triggered after ingesting one or specific food groups. Gluten, wheat and related proteins (e.g., amylase-trypsin inhibitors, and fermentable oligo-di-mono-saccharides and polyols (FODMAPs) are the most relevant IBS symptom triggers, although the true ‘culprit(s)’ is/are still not well established. The concept of causal relationship between gluten intake and the occurrence of symptoms in the absence of celiac disease and wheat allergy was termed non-celiac gluten sensitivity (NCGS). The borderline between celiac disease, wheat allergy, IBS and NCGS is not always clearly distinguishable, and the frequency and clinical identity of NGCS are still unclear. An overlap between IBS and NCGS has been detected. The incomplete knowledge of the etiopathogenesis of these clinical conditions, lack of data on their real epidemiology, as well as the absence of a gold standard for their diagnosis, make the overall picture difficult to understand “It is crucial to well define the interaction between IBS, food intolerance and NGCS, since the role of diet in IBS and its dietary management is an essential tool in the treatment of a large number of these patients”. The objective of the present review is to provide an overview highlighting the interaction between IBS, food intolerance and NCGS in order to unravel whether gluten/wheat/FODMAP sensitivity represents ‘facts’ and not ‘fiction’ in IBS symptoms.

scholarly journals Non-Celiac Gluten Sensitivity: A Challenging Diagnosis in Children with Abdominal Pain

2018 ◽  
Vol 73 (Suppl. 4) ◽  
pp. 39-46 ◽  
Author(s):  
Frank M. Ruemmele
Keyword(s):  
Abdominal Pain ◽  
Celiac Disease ◽  
Clinical Symptoms ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Clear Cut ◽  
Clinical Presentations ◽  
New Findings ◽  
Three Phase ◽  
Gi Symptoms

Several disorders related to the ingestion of gluten are well recognized despite overlapping clinical presentations: celiac disease, an autoimmune enteropathy triggered by gluten ingestions in susceptible individuals, allergy to wheat, and more recently non-celiac gluten sensitivity (NCGS). While celiac disease and wheat allergy are well-known disorders with a clear-cut diagnosis based on clinical tests and biological parameters, NCGS is a more difficult diagnosis, especially in children with functional gastrointestinal (GI) complaints. NCGS is considered a syndrome of intestinal but also extraintestinal symptoms occurring within hours, but sometimes even after several days of gluten ingestion. In children, the leading symptoms of NCGS are abdominal pain and diarrhea, while extraintestinal symptoms are rare, in contrast to adult patients. No precise diagnostic test nor specific biomarkers exist, except a rather cumbersome three-phase gluten-exposure, gluten-free diet, followed by a blinded placebo-controlled gluten challenge with crossover to provoke symptoms elicited by gluten in a reproducible manner that disappear on gluten-free alimentation. Recent data indicate that the peptide part of wheat proteins is not necessarily the sole trigger of clinical symptoms. Mono- or oligosaccharides, such as fructan and other constituents of wheat, were able to provoke GI symptoms in clinical trials. These new findings indicate that the term gluten sensitivity is probably too restrictive. The incidence of NCGS was reported in the range of 1–10% in the general population and to increase steadily; however, most data are based on patients’ self-reported gluten intolerance or avoidance without a medically confirmed diagnosis. Treatment consists of gluten avoidance for at least several weeks or months. Patients with NCGS require regular reassessment for gluten tolerance allowing with time the reintroduction of increasing amounts of gluten.

scholarly journals Irritable Bowel Syndrome and Gluten-Related Disorders

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1117 ◽  
Author(s):  
Paolo Usai-Satta ◽  
Gabrio Bassotti ◽  
Massimo Bellini ◽  
Francesco Oppia ◽  
Mariantonia Lai ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Celiac Disease ◽  
The Other ◽  
Gluten Free Diet ◽  
Gluten Free ◽  
Gut Permeability ◽  
Online Search ◽  
Systematic Screening ◽  
Wheat Sensitivity ◽  
Irritable Bowel

Background: Irritable bowel syndrome (IBS) is frequently associated with celiac disease (CD) and nonceliac gluten/wheat sensitivity (NCGS/NCWS), but epidemiological and pathophysiological aspects are still unclear. Furthermore, a gluten-free diet (GFD) can positively influence IBS symptoms. Methods: A comprehensive online search for IBS related to CD, NCGS and GFD was made using the Pubmed, Medline and Cochrane databases. Results: Although a systematic screening for CD in IBS is not recommended, CD prevalence can be increased in diarrhea-predominant IBS patients. On the other hand, IBS symptoms can be persistent in treated CD patients, and their prevalence tends to decrease on a GFD. IBS symptoms may overlap and be similar to those associated to nonceliac gluten and/or wheat sensitivity. Increased gut permeability could explain the gluten/wheat effects in IBS patients. Finally, a GFD could improve symptoms in a subgroup of IBS patients. Conclusions: The possible interplay between IBS and gluten-related disorders represents a scientifically and clinically challenging issue. Further studies are needed to confirm these data and better clarify the involved pathophysiological mechanisms.

scholarly journals The gluten free diet in depth

2017 ◽  
Vol 1 (1) ◽  
pp. 7
Author(s):  
Caroline Kanaan
Keyword(s):  
Irritable Bowel Syndrome ◽  
Neuropsychiatric Disorders ◽  
Healthy Diet ◽  
Gluten Free Diet ◽  
Gluten Sensitivity ◽  
Gluten Free ◽  
Irritable Bowel ◽  
New Research ◽  
New Diagnosis

The gluten free diet has been gaining recognition globally and is being applied by many patients. This diet was first developed for Celiac's patients however with the emergence of a new diagnosis: non-celiac gluten sensitivity (NCGS), more patients are finding relief from their symptoms when following this diet. The symptoms of NCGS also overlap with those of Irritable Bowel Syndrome and there are studies that suggest a possible link between NCGS and neuropsychiatric disorders, like autism and others. In this presentation we will review the new research about gluten and also answer the following questions. Where is gluten found? How to remove it from the diet? How to follow a healthy diet?.

scholarly journals Gluten and FODMAPS—Sense of a Restriction/When Is Restriction Necessary?

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1957 ◽  
Author(s):  
Walburga Dieterich ◽  
Yurdagül Zopf
Keyword(s):  
Celiac Disease ◽  
Clinical Symptoms ◽  
Gastrointestinal Symptoms ◽  
Nutritional Deficiencies ◽  
Symptom Improvement ◽  
Standard Diet ◽  
Gluten Free ◽  
First Choice ◽  
Irritable Bowel ◽  
Fodmap Diet

Gluten-free diet (GFD) is enjoying increasingly popularity, although gluten-free products are considerably more expensive. GFD is absolutely necessary for patients with celiac disease, as in this case even minor amounts of gluten can lead to the destruction of the intestinal mucosa. In addition, GFD is currently the best therapy to improve clinical symptoms of patients with non-celiac gluten sensitivity (NCGS), although the diet may not be as strict as that for patients with celiac disease. Beside gluten, other wheat components such as oligosaccharides and amylase trypsin inhibitors are discussed as triggers of NCGS in this review. An overlap between gastrointestinal symptoms in NCGS and irritable bowel syndrome (IBS) is described. Patients with NCGS attribute their symptoms to the consumption of gluten, while patients with IBS rarely describe gluten as a trigger. Recently, several studies have demonstrated that the introduction of a low FODMAP (fermentable oligo-, di-, monosaccharides, and polyols) diet reduced gastrointestinal symptoms in patients with IBS and this diet is suggested as the first choice of therapy in IBS. However, a low FODMAP diet also eliminates prebiotica and may negatively influence the gut microbiota. For this reason, the diet should be liberalized after symptom improvement. There is no evidence that a GFD is healthier than the standard diet. In contrast, GFD often is accompanied by nutritional deficiencies, mainly minerals and vitamins. Therefore, GFD and low FODMAP diets are not recommended for healthy subjects. Since wheat contains fructans belonging to FODMAPs), a GFD is not only gluten-free but also has less FODMAPs. Thus, symptom improvement cannot be correctly correlated with the reduction of either one or the other.

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