Celiac Disease or Gluten Related Disorders? Who Would Be the Disease of the Time?

-Background -Celiac disease is a permanent intolerance induced by gluten, which is expressed by T-cell mediated enteropathy, and has a high prevalence in the general population. There is evidence of a strong genetic predisposition to celiac disease. Objective -To determine the prevalence of genetic markers HLA-DQ2 and HLA-DQ8 in blood donors from São Paulo and measure human recombinant tissue transglutaminase antibody IgA class in HLA-DQ2 and HLA-DQ8 positive donors.Methods -A total of 404 blood donors from São Paulo city and Jundiaí were included in the study and signed the informed consent form. Information regarding diarrhea, constipation and abdominal pain in the last 3 months was collected. Determination of HLADQ2 and HLADQ8 alleles was performed in all participants and human recombinant tissue transglutaminase antibody class IgA was measured only in blood donors who presentedDQ2 and/or DQ8. Results -HLADQ2 and/or HLADQ8 were positive in 49% (198/404) of subjects. Positive samples were associated with alleles DR3, DR4, DR7, DR11 and DR12. The most frequent genotype was DR4-DQ8, which was present in 13.6% of samples, followed by genotypes DR3-DQ2 and DR7-DQ2 with DQB1*02 in heterozygous, which were present in 10.4% and 8.7%, respectively. Eleven out of 198 positive donors (5%) were positive to human tissue transglutaminase test. Conclusion -We observed a high prevalence of genetic markers for celiac disease, HLA-DQ2 and HLA-DQ8, in blood donors from São Paulo, similar to prevalence described in Europe. These findings show that the prevalence of celiac disease should not be rare in our country, but underdiagnosed.

Section: Introductionmentioning

confidence: 99%

Prevalence of Genetic Susceptibility for Celiac Disease in Blood Donors in São Paulo, Brazil

Muniz

Sdepanian

Neto

2016

“…However, the component (s) of this cereal that is directly involved in generating the symptoms of IBS remains unknown. Gluten, other wheat proteins, for example, amylase-trypsin inhibitors and fructans (the latter belonging to FODMAPs) have been identified as possible factors for the generation and or exacerbation of IBS symptoms (27,28,(37)(38)(39)(40)(41)(42)(43)48) . Symptoms related to FODMAPs share the same clinical characteristics associated with lactose intolerance and many foods rich in FODMAPs are also rich in lactose.…”

Section: Ibs and Food Intolerancementioning

confidence: 99%

“…The increase in the global prevalence of celiac disease may be true or associated with an increase in the number of diagnostic serological tests. In the case of NCGS, the increase in prevalence could be associated with an increase in global wheat consumption in the last decades (27,35,36,37,54) . The varied food forms of wheat contain more gluten than in the past and could be associated with digestive symptoms (52,53) .…”

Section: Iii-gluten Related Disorders -Ncgs and Ibsmentioning

confidence: 99%

“…An overlap between IBS and NCGS has been detected. However, 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 (22,(27)(28)(34)(35)(36)(37)44,45,57,58,(61)(62)(63) . 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 (52,61,63,68,72,73) .…”

Section: Iii-gluten Related Disorders -Ncgs and Ibsmentioning

confidence: 99%

“…In addition, it has recently been reported that a percentage of patients with a negative diagnosis for celiac disease reported that foods containing gluten triggered the symptoms of IBS. This association is included in the concept of IBS-like disorders (27)(28)(29)(30)(31)(32)(33)(34)(35)(36) . A subset of patients diagnosed with IBS report worsening symptoms when they eat foods that contain gluten and improve with the withdrawal of these foods from the diet.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Irritable Bowel Syndrome, Food Intolerance and Non- Celiac Gluten Sensitivity. A New Clinical Challenge

Soares

2018

Self Cite

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.

Analysis of Lactose Intolerance in Students With Suggestive Symptoms of Irritable Bowel Syndrome

Silva

Leite

Rodrigues

et al. 2019

BACKGROUND: Irritable bowel syndrome is a clinical condition presenting pain, distension and abdominal fullness, diarrhea, constipation, and other symptoms. It generates significant impacts on the quality of life of those affected. The pathophysiology is uncertain, but the role of various food types has been established in bowel sensitivity and its clinical manifestations. Carbohydrate intolerance, particularly to lactose, generates similar and sometimes indistinguishable symptoms from irritable bowel syndrome, and in clinical practice is both a frequent and underdiagnosed condition. Carbohydrate intolerance is related to enzymatic deficiencies, alterations of intestinal microbiota and even genetic change. The principal test for a diagnosis of lactose intolerance is the breath test, which measures hydrogen emission (produced only by bacteria), after ingestion of the corresponding substrate. OBJECTIVE: The present work aims to verify the prevalence of lactose intolerance in university students, presenting gastrointestinal symptoms suggestive of irritable bowel syndrome. METHODS: In a transversal study, to screen for those with suggestive symptoms, 124 medicine students participated by responding to a form. Those with abdominal pain were referred for anti-parasite treatment in order to exclude intestinal parasites as a secondary cause. Subsequently, using the hydrogen breath test, bacterial overgrowth was investigated, and if negative, lactose intolerance testing would be performed. Patients presenting high hydrogen concentrations of ≥20 ppm above the basal level were considered lactose intolerant. RESULTS: Of the total of students researched (n=124), 7 were excluded because they did not completing all study phases. From those 117 individuals effectively included in the survey; 8 (6.8%) were diagnosed with lactose intolerance and 2 (1.7%) with bacterial overgrowth. Intolerance was more frequent in; female individuals (75%), age range 18 to 25 years (62.5%), being colored (50%), and in their 5th semester of studies (37.5%). The presence of at least one gastrointestinal symptom among those presenting intolerance (100%), and those not presenting intolerance (42.2%) was found (P=0.002). In addition to abdominal pain (100%) (P<0.001), the most recurrent gastrointestinal symptom in the lactose intolerant students was the distension/flatulence (62.5%) (P=0.026). In relation to life habits and food patterns, there was no statistical difference between lactose tolerant and intolerant individuals, or for symptom frequencies. The more advanced students, completing more periods towards graduation, demonstrated more occurrences of gastrointestinal symptoms, yet without presenting significant statistical discrepancies. CONCLUSION: In view of the test sample quantity (n=21), a high prevalence of lactose intolerance (6.8%) in the academic environment, with epidemiological characteristics compatible to those found the literature is demonstrated, generating knowledge with understanding to prevent, diagnose, alleviate and treat lactose intolerant university students, and generate positive impacts towards well-being, improving the quality of life of these individuals.