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. 2017 Sep;62(9):2449-2454.
doi: 10.1007/s10620-017-4666-z. Epub 2017 Jul 7.

Symptoms of Functional Intestinal Disorders Are Common in Patients with Celiac Disease Following Transition to a Gluten-Free Diet

Jocelyn A Silvester  1   2   3 , Lesley A Graff  1 , Lisa Rigaux  4 , Charles N Bernstein  1 , Daniel A Leffler  3 , Ciarán P Kelly  3 , John R Walker  1 , Donald R Duerksen  5   6   7
Affiliations

Symptoms of Functional Intestinal Disorders Are Common in Patients with Celiac Disease Following Transition to a Gluten-Free Diet

Jocelyn A Silvester et al. Dig Dis Sci. 2017 Sep.

Abstract

Background: Celiac disease and functional intestinal disorders may overlap, yet the natural history of functional symptoms in patients with celiac disease is unknown.

Aim: To investigate the prevalence of irritable bowel syndrome (IBS), functional dyspepsia (FD), and functional bloating (FB) symptoms among patients with celiac disease at diagnosis and during the first year of a gluten-free diet.

Methods: Adults with a new diagnosis of celiac disease were surveyed at baseline, 6 months and 1 year using standardized measures for intestinal symptoms [Rome III diagnostic questionnaire and celiac symptom index (CSI)] and gluten-free diet adherence [gluten-free eating assessment tool (GF-EAT) and celiac diet adherence test].

Results: At diagnosis, two-thirds fulfilled Rome III diagnostic questionnaire symptom criteria for IBS (52%), functional dyspepsia (27%), and/or functional bloating (9%). One year post-diagnosis, there was high adherence to a gluten-free diet as 93% reported gluten exposure less than once per month on the GF-EAT and only 8% had ongoing celiac disease symptoms (CSI score >45). The rates of those meeting IBS (22%) and functional dyspepsia (8%) symptom criteria both decreased significantly on a gluten-free diet. The prevalence of functional symptoms (any of IBS, FD or FB) at 1 year was 47%.

Conclusions: Long-term follow-up of patients with celiac disease is necessary because many patients with celiac disease who are adherent to a gluten-free diet have persistent gastrointestinal symptoms.

Keywords: Celiac disease; Functional bloating; Functional dyspepsia; Gluten-free diet; Irritable bowel syndrome; Prospective cohort study.

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