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The Overlap between Irritable Bowel Syndrome and Non-Celiac Gluten Sensitivity: A Clinical Dilemma.
Nutrients 2015; 7(12):10417-26N

Abstract

The spectrum of gluten-related disorders has widened in recent times and includes celiac disease, non-celiac gluten sensitivity, and wheat allergy. The complex of symptoms associated with these diseases, such as diarrhea, constipation or abdominal pain may overlap for the gluten related diseases, and furthermore they can be similar to those caused by various other intestinal diseases, such as irritable bowel syndrome (IBS). The mechanisms underlying symptom generation are diverse for all these diseases. Some patients with celiac disease may remain asymptomatic or have only mild gastrointestinal symptoms and thus may qualify for the diagnosis of IBS in the general clinical practice. Similarly, the overlap of symptoms between IBS and non-celiac gluten sensitivity (NCGS) often creates a dilemma for clinicians. While the treatment of NCGS is exclusion of gluten from the diet, some, but not all, of the patients with IBS also improve on a gluten-free diet. Both IBS and NCGS are common in the general population and both can coexist with each other independently without necessarily sharing a common pathophysiological basis. Although the pathogenesis of NCGS is not well understood, it is likely to be heterogeneous with possible contributing factors such as low-grade intestinal inflammation, increased intestinal barrier function and changes in the intestinal microbiota. Innate immunity may also play a pivotal role. One possible inducer of innate immune response has recently been reported to be amylase-trypsin inhibitor, a protein present in wheat endosperm and the source of flour, along with the gluten proteins.

Authors+Show Affiliations

Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. govindmakharia@gmail.com.Department of Pediatrics, Università Politecnica delle Marche, 60123 Ancona, Italy. c.catassi@univpm.it.Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. govindmakharia@gmail.com.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26690475

Citation

Makharia, Archita, et al. "The Overlap Between Irritable Bowel Syndrome and Non-Celiac Gluten Sensitivity: a Clinical Dilemma." Nutrients, vol. 7, no. 12, 2015, pp. 10417-26.
Makharia A, Catassi C, Makharia GK. The Overlap between Irritable Bowel Syndrome and Non-Celiac Gluten Sensitivity: A Clinical Dilemma. Nutrients. 2015;7(12):10417-26.
Makharia, A., Catassi, C., & Makharia, G. K. (2015). The Overlap between Irritable Bowel Syndrome and Non-Celiac Gluten Sensitivity: A Clinical Dilemma. Nutrients, 7(12), pp. 10417-26. doi:10.3390/nu7125541.
Makharia A, Catassi C, Makharia GK. The Overlap Between Irritable Bowel Syndrome and Non-Celiac Gluten Sensitivity: a Clinical Dilemma. Nutrients. 2015 Dec 10;7(12):10417-26. PubMed PMID: 26690475.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Overlap between Irritable Bowel Syndrome and Non-Celiac Gluten Sensitivity: A Clinical Dilemma. AU - Makharia,Archita, AU - Catassi,Carlo, AU - Makharia,Govind K, Y1 - 2015/12/10/ PY - 2015/11/02/received PY - 2015/11/25/revised PY - 2015/12/04/accepted PY - 2015/12/23/entrez PY - 2015/12/23/pubmed PY - 2016/9/20/medline KW - celiac disease KW - gluten-related disorders KW - intestine KW - pathogenesis KW - wheat allergy SP - 10417 EP - 26 JF - Nutrients JO - Nutrients VL - 7 IS - 12 N2 - The spectrum of gluten-related disorders has widened in recent times and includes celiac disease, non-celiac gluten sensitivity, and wheat allergy. The complex of symptoms associated with these diseases, such as diarrhea, constipation or abdominal pain may overlap for the gluten related diseases, and furthermore they can be similar to those caused by various other intestinal diseases, such as irritable bowel syndrome (IBS). The mechanisms underlying symptom generation are diverse for all these diseases. Some patients with celiac disease may remain asymptomatic or have only mild gastrointestinal symptoms and thus may qualify for the diagnosis of IBS in the general clinical practice. Similarly, the overlap of symptoms between IBS and non-celiac gluten sensitivity (NCGS) often creates a dilemma for clinicians. While the treatment of NCGS is exclusion of gluten from the diet, some, but not all, of the patients with IBS also improve on a gluten-free diet. Both IBS and NCGS are common in the general population and both can coexist with each other independently without necessarily sharing a common pathophysiological basis. Although the pathogenesis of NCGS is not well understood, it is likely to be heterogeneous with possible contributing factors such as low-grade intestinal inflammation, increased intestinal barrier function and changes in the intestinal microbiota. Innate immunity may also play a pivotal role. One possible inducer of innate immune response has recently been reported to be amylase-trypsin inhibitor, a protein present in wheat endosperm and the source of flour, along with the gluten proteins. SN - 2072-6643 UR - https://www.unboundmedicine.com/medline/citation/26690475/full_citation L2 - http://www.mdpi.com/resolver?pii=nu7125541 DB - PRIME DP - Unbound Medicine ER -