A Study Evaluating the Bidirectional Relationship Between Inflammatory Bowel Disease and Self-reported Non-celiac Gluten Sensitivity

Aziz, Imran; Branchi, Federica; Pearson, Katherine; Priest, Josephine; Sanders, David S.

doi:10.1097/mib.0000000000000335

Cited by 58 publications

(46 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the study by Aziz et al characteristics of CrD in patients with self-reported non-celiac gluten sensitivity (SR-NCGS) compared to those without SR-NCGS were demonstrated [9]. They suggest, subjects with SR-NCGS were significantly more likely to have stricturing disease and a higher mean Crohn's Disease Activity Index (CDAI) score compared with those without SR-NCGS, whereas moderate-to-severe CDAI score was significantly associated with SR-NCGS and a score of <150 was significantly associated with those who did not reporting non-celiac gluten sensitivity.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Gluten-free Diet for Refractory Inflammatory Bowel Disease; A Case Report

Rostami‐Nejad¹,

Sadeghi²,

Asadzadeh‐Aghdaei³

et al. 2017

IJCD

View full text Add to dashboard Cite

Some factors include environmental triggers have role in development of intestinal inflammation in inflammatory bowel disease (IBD). A number of patients with IBD, experience improvement in their gastrointestinal symptoms and disease course when avoiding gluten. To highlight this issue we present a 28years old male patient, known case of ulcerative colitis, was admitted to the hospital for a flare-up of his disease. He presented with bloody diarrhea despite the fact that he was on long term variable dose of oral and topical Asacol since 4 years ago and azathioprine 2.5mg/kg/day prescribed for his persistent symptoms since last year. In spite of drug adherence, he experienced 3 flare-ups during past year and refused receiving prednisolone. Colonoscopy demonstrated severe erythema, multiple erosions and friability through the left colon from rectum up to splenic flexure. Histopathological evaluation revealed crypt architecture distortion with moderate increase in lymphoplasmacytic infiltration as well as neutrophilic activity in the form of cryptitis and crypt abscess formation. Upper GI endoscopy followed by duodenal biopsies and serological evaluation were negative for celiac disease. Before considering anti-TNF agents, patient underwent a gluten-free diet (GFD) and with a positive response, it continued for 6 weeks. After 6 weeks GFD his bloody diarrhea was nearly resolved and 12 weeks later most of his symptoms disappeared and entered to the full clinical remission. He stopped the diet and 12 weeks later his symptoms returned and experienced another relapse that again improved on GFD.As an environmental factor, gluten represents a strong antigen that might be implicated in the pathogenesis of at least a number of patients with IBD. Dietary restriction of gluten might be useful in some IBD patients during the exacerbation of their disease.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Theoretically more frequent disease flares and the need for more intensified therapies could be triggered by gluten containing diet that makes proinflammatory environment in the intestine, similar to patients with IBD and concurrent celiac disease [9].…”

Section: Discussionmentioning

confidence: 99%

Gluten-free Diet for Refractory Inflammatory Bowel Disease; A Case Report

Rostami‐Nejad¹,

Sadeghi²,

Asadzadeh‐Aghdaei³

et al. 2017

IJCD

View full text Add to dashboard Cite

show abstract

“…106 Our group has generated similar results and also found that patients with Crohn's disease who self-report NCGS are markedly more likely to have severe or stricturing disease than those without self-reported NCGS. 107 Furthermore, we evaluated the converse relationship and identified that in 200 patients presenting with selfreported NCGS the majority had perceived dietaryrelated IBS (98.5%) but a minority had IBD (1.5%); such patients presented with associated alarm symptoms and/ or abnormal blood parameters, prompting colonic investigations. This pathophysiological relationship between IBD and self-reported NCGS is unknown but could be due to the physical properties of gluten-based products as a volume effect, or alternatively, there might be a specific immune response that has yet to be explored.…”

Section: Recommending Gfd In Diarrhoea-predominant Ibsmentioning

confidence: 99%

“…Randomized studies are now required to clarify whether a GFD is a valuable option in selected patients with IBD. 107 Novel diagnostic techniques Potential biomarkers to help diagnose NCGS have been evaluated. In vitro flow cytometry basophil activation tests, based on cell surface expression of CD63, initially showed promising results when compared with DBPC dietary rechallenges, with 86% sensitivity, 88% specificity and 87% accuracy.…”

Section: Recommending Gfd In Diarrhoea-predominant Ibsmentioning

confidence: 99%

The spectrum of noncoeliac gluten sensitivity

Aziz

Hadjivassiliou

Sanders

2015

Nat Rev Gastroenterol Hepatol

Self Cite

View full text Add to dashboard Cite

The past 5 years have seen an increase in the use of a gluten-free diet outside a diagnosis of coeliac disease or IgE-mediated wheat allergy. This trend has led to the identification of a new clinical entity termed noncoeliac gluten sensitivity (NCGS). In this Review, we discuss the evidence for NCGS as demonstrated by the results of double-blind, placebo-controlled dietary rechallenge studies. Furthermore, the characteristic phenotype of individuals with NCGS is described as well as the symptom manifestations commonly reported after gluten exposure, which include intestinal symptoms consistent with IBS, and extraintestinal symptoms such as neurological dysfunction, psychological disturbances, fibromyalgia and skin rash. Moreover, emerging evidence suggests that NCGS can be associated with organic gastrointestinal pathologies, such as IBD, in which its presence might be a reflection of severe or stricturing disease. However, NCGS is not without its controversies and uncertainties, in particular pertaining to whether it is gluten or nongluten components of the grain evoking symptoms; evidence suggests that fermentable carbohydrates, amylase trypsin inhibitors and wheat-germ agglutinin can also be responsible culprits. Finally, we discuss the novel techniques that might help diagnose NCGS in the future.

show abstract

“…Upon GFD, his symptoms disappeared and the colonic pathology improved. It should be noted that other recent reports on Crohn's disease patients reported that GFD might be beneficial in reducing gastrointestinal symptoms, disease activity index and drug responsiveness [9,10,11]. The present editorial will review the non-CD ADs that under certain circumstances responded to GFD, and the potential mechanism relaying gluten withdrawal to the improvement of autoimmune diseases and their responsiveness.…”

Section: Introductionmentioning

confidence: 99%

Are Non-Celiac Autoimmune Diseases Responsive to Gluten-Free Diet?

Lerner¹,

Ramesh²,

Tenbusch³

2017

IJCD

View full text Add to dashboard Cite

Genetic risk factors for autoimmune diseases are constantly discovered, however, environmental factors are laggingbehind and the precipitating events leading to development of autoimmune diseases remain enigmatic. Gluten is a well-established inducing nutrient in celiac disease and gluten withdrawal is the only current effective therapy. More and more studies have shown that non-celiac autoimmune diseases can partially respond to gluten free diet. The present editorial reviews those conditions and suggest multiple potential mechanisms that might operate in clinical amelioration of non-celiac autoimmune diseases.

show abstract

A Study Evaluating the Bidirectional Relationship Between Inflammatory Bowel Disease and Self-reported Non-celiac Gluten Sensitivity

Cited by 58 publications

References 46 publications

Gluten-free Diet for Refractory Inflammatory Bowel Disease; A Case Report

Gluten-free Diet for Refractory Inflammatory Bowel Disease; A Case Report

The spectrum of noncoeliac gluten sensitivity

Are Non-Celiac Autoimmune Diseases Responsive to Gluten-Free Diet?

Contact Info

Product

Resources

About