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Dietary Triggers in Irritable Bowel Syndrome: Is There a Role for Gluten?
J Neurogastroenterol Motil. 2016 Oct 30; 22(4):547-557.JN

Abstract

A tight link exists between dietary factors and irritable bowel syndrome (IBS), one of the most common functional syndromes, characterized by abdominal pain/discomfort, bloating and alternating bowel habits. Amongst the variety of foods potentially evoking "food sensitivity", gluten and other wheat proteins including amylase trypsin inhibitors represent the culprits that recently have drawn the attention of the scientific community. Therefore, a newly emerging condition termed non-celiac gluten sensitivity (NCGS) or nonceliac wheat sensitivity (NCWS) is now well established in the clinical practice. Notably, patients with NCGS/NCWS have symptoms that mimic those present in IBS. The mechanisms by which gluten or other wheat proteins trigger symptoms are poorly understood and the lack of specific biomarkers hampers diagnosis of this condition. The present review aimed at providing an update to physicians and scientists regarding the following main topics: the experimental and clinical evidence on the role of gluten/wheat in IBS; how to diagnose patients with functional symptoms attributable to gluten/wheat sensitivity; the importance of double-blind placebo controlled cross-over trials as confirmatory assays of gluten/wheat sensitivity; and finally, dietary measures for gluten/wheat sensitive patients. The analysis of current evidence proposes that gluten/wheat sensitivity can indeed represent a subset of the broad spectrum of patients with a clinical presentation of IBS.

Links

PMC Free PDF

Authors+Show Affiliations

Volta U
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Pinto-Sanchez MI
Department of Medicine, McMaster University, Farncombe Institute, Hamilton, Ontario, Canada.
Boschetti E
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Caio G
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
De Giorgio R
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Verdu EF
Department of Medicine, McMaster University, Farncombe Institute, Hamilton, Ontario, Canada.

Pub Type(s)

Review
Journal Article

Language

eng

PubMed ID

27426486

Clinical Trial Links

Anemia in Non-celiac Wheat Sensitivity
Dietary Triggers of Gastrointestinal Symptoms in IBS Patients

Citation

Volta, Umberto, et al. "Dietary Triggers in Irritable Bowel Syndrome: Is There a Role for Gluten?" Journal of Neurogastroenterology and Motility, vol. 22, no. 4, 2016, pp. 547-557.
Volta U, Pinto-Sanchez MI, Boschetti E, et al. Dietary Triggers in Irritable Bowel Syndrome: Is There a Role for Gluten? J Neurogastroenterol Motil. 2016;22(4):547-557.
Volta, U., Pinto-Sanchez, M. I., Boschetti, E., Caio, G., De Giorgio, R., & Verdu, E. F. (2016). Dietary Triggers in Irritable Bowel Syndrome: Is There a Role for Gluten? Journal of Neurogastroenterology and Motility, 22(4), 547-557. https://doi.org/10.5056/jnm16069
Volta U, et al. Dietary Triggers in Irritable Bowel Syndrome: Is There a Role for Gluten. J Neurogastroenterol Motil. 2016 Oct 30;22(4):547-557. PubMed PMID: 27426486.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary Triggers in Irritable Bowel Syndrome: Is There a Role for Gluten? AU - Volta,Umberto, AU - Pinto-Sanchez,Maria Ines, AU - Boschetti,Elisa, AU - Caio,Giacomo, AU - De Giorgio,Roberto, AU - Verdu,Elena F, PY - 2016/4/27/received PY - 2016/6/2/accepted PY - 2016/7/19/pubmed PY - 2016/7/19/medline PY - 2016/7/19/entrez PY - 2016/10/1/pmc-release KW - Biomarkers KW - Dietary factors KW - Functional bowel disorder KW - Gluten KW - Wheat SP - 547 EP - 557 JF - Journal of neurogastroenterology and motility JO - J Neurogastroenterol Motil VL - 22 IS - 4 N2 - A tight link exists between dietary factors and irritable bowel syndrome (IBS), one of the most common functional syndromes, characterized by abdominal pain/discomfort, bloating and alternating bowel habits. Amongst the variety of foods potentially evoking "food sensitivity", gluten and other wheat proteins including amylase trypsin inhibitors represent the culprits that recently have drawn the attention of the scientific community. Therefore, a newly emerging condition termed non-celiac gluten sensitivity (NCGS) or nonceliac wheat sensitivity (NCWS) is now well established in the clinical practice. Notably, patients with NCGS/NCWS have symptoms that mimic those present in IBS. The mechanisms by which gluten or other wheat proteins trigger symptoms are poorly understood and the lack of specific biomarkers hampers diagnosis of this condition. The present review aimed at providing an update to physicians and scientists regarding the following main topics: the experimental and clinical evidence on the role of gluten/wheat in IBS; how to diagnose patients with functional symptoms attributable to gluten/wheat sensitivity; the importance of double-blind placebo controlled cross-over trials as confirmatory assays of gluten/wheat sensitivity; and finally, dietary measures for gluten/wheat sensitive patients. The analysis of current evidence proposes that gluten/wheat sensitivity can indeed represent a subset of the broad spectrum of patients with a clinical presentation of IBS. SN - 2093-0879 UR - https://www.unboundmedicine.com/medline/citation/27426486/full_citation DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓27 ↑94]

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