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Symptoms of IBS may be triggered by gluten despite absence of ‘classic’ celiac intestinal damage & immune markers

  [ 14 votes ]   [ 1 Comment ] • January 16, 2011

Gluten Causes Gastrointestinal Symptoms in Subjects Without Celiac Disease: A Double-Blind Randomized Placebo-Controlled Trial – Source: American Journal of Gastroenterology, Jan 11, 2011

by Jessica R Biesiekierski, et al.

Objectives: Despite increased prescription of a gluten-free diet for gastrointestinal symptoms in individuals who do not have celiac disease, there is minimal evidence that suggests that gluten is a trigger.

The aims of this study were to determine whether gluten ingestion can induce symptoms in non-celiac individuals and to examine the mechanism.

Methods: A double-blind, randomized, placebo-controlled rechallenge trial was undertaken in patients:

• With irritable bowel syndrome

• In whom celiac disease was excluded

• And who were symptomatically controlled on a gluten-free diet.

Participants received either gluten or placebo in the form of two bread slices plus one muffin per day with a gluten-free diet for up to 6 weeks.

Symptoms were evaluated using a visual analog scale and markers of intestinal inflammation, injury, and immune activation were monitored.

Results: A total of 34 patients (aged 29-59 years, 4 men) completed the study as per protocol. Overall, 56% had human leukocyte antigen (HLA)-DQ2 and/or HLA-DQ8.

Adherence to diet and supplements was very high.

Of 19 patients in the gluten group, 13 (68%) reported that symptoms were not adequately controlled compared with 6 of 15 (40%) on placebo (P=0.0001; generalized estimating equation).

On a visual analog scale, patients were significantly worse with gluten within 1 week for:

• Overall symptoms (P=0.047),

• Pain (P=0.016),

• Bloating (P=0.031),

• Satisfaction with stool consistency (P=0.024),

• And tiredness (P=0.001).

Anti-gliadin antibodies were not induced. There were no significant changes in fecal lactoferrin, levels of celiac antibodies, highly sensitive C-reactive protein, or intestinal permeability. There were no differences in any end point in individuals with or without DQ2/DQ8.

Conclusions: "Non-celiac gluten intolerance" may exist, but no clues to the mechanism were elucidated.

Source: American Journal of Gastroenterology, Jan 11, 2011. PMID: 21224837, by Biesiekierski JR, Newnham ED, Irving PM, Barrett JS, Haines M, Doecke JD, Shepherd SJ, Muir JG, Gibson PR. Monash University Department of Medicine and Gastroenterology, Box Hill Hospital, Box Hill, Victoria, Australia. [Email:]

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Article Comments Post a Comment

gluten and leaky gut
Posted by: Sandy10m
Jan 22, 2011
This fact has been known for a while, since leaky gut is usually the underlying problem, and gluten getting into your blood stream can cause SERIOUS problems. Most MDs don't believe that a candida infection of the intestines can cause leaky gut, but I am living proof that it can. I was rigorously tested for candida during treatment, and my symptoms correlated directly with the test results. It took me a long time to figure out the secret combination to cure myself, but anyone can try the regimen. You should be able to cure your candida within 3 months. The 2 pieces of the puzzle are: Paleolithic (Caveman) diet, and oral powdered Nystatin (an antifungal prescription). I am candida free, IBS free, and gluten-intolerance free from doing this treatment. Good luck!
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