Screening for Celiac Disease in Irritable Bowel Syndrome: An Updated Systematic Review and Meta-analysis

Irvine, Andrew J; Chey, William D.; Ford, Alexander C

doi:10.1038/ajg.2016.466

Cited by 131 publications

(92 citation statements)

References 68 publications

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“…In the clinical suspicion of thyroid disease, a thyroid profile should be performed. Serologic tests for celiac disease should be used to exclude this condition in patients with symptoms of IBS-D and IBS-M [1,49]. Other differential diagnoses include bile-acid-induced diarrhoea and carbohydrate malabsorption.…”

Section: Laboratory Testsmentioning

confidence: 99%

Irritable Bowel Syndrome: News from an Old Disorder

Ferreira

Garrido

Castro-Poças

2019

GE Port J Gastroenterol

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Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder, which can affect all members of a society, regardless of age, sex, race or socioeconomic status. Because of its high prevalence and chronic nature, it represents a significant economic burden. In fact, these patients have a relevant impairment of their quality of life, which limits their work productivity and daily social activities, especially when it is associated with other disorders, such as anxiety and depression. The diagnosis of IBS relies on symptom-based diagnostic criteria with normal results on a limited number of complementary tests that rule out other possible diagnoses. The aetiology of this condition is incompletely established. However, evidence suggests that it is a multifactorial disorder with several different mechanisms that have been implicated as responsible for the symptoms. Since the treatment strategy is usually based on predominant symptoms and their severity, it is important to recognise the underlying mechanisms in order to successfully relief the visceral pain and altered bowel habits. The aim of this non-systematic review of the literature was to explore the pathophysiology and treatment options of IBS, highlighting the most recent evidence, from the new Rome IV criteria to the new drug armamentarium. Síndrome do intestino irritável: novidades de uma doença antiga Palavras ChaveSíndrome do intestino irritável · Revisão · Critérios Rome Resumo A síndrome do intestino irritável é um distúrbio gastrointestinal funcional, que pode afetar todos os membros da sociedade, independentemente da idade, sexo, raça ou estrato socioeconómico. Devido à sua elevada prevalência e natureza crónica, representa um encargo económico significativo. De facto, estes doentes apresentam uma alteração relevante da sua qualidade de vida, o que limita a sua produtividade laboral e atividades de vida diárias, sobretudo quando está associada a outros distúrbios, tais como ansiedade e depressão. O diagnóstico da síndrome do intestino irritável depende de critérios diagnósticos baseados em sintomas, com resultados normais num número limitado de testes complementares que exluem outros diagnósticos possíveis. A etiologia desta doença não está completamente estabelecida. No entanto, a evidência sugere que se trata de um distúrbio multifatorial com vários mecanismos diferentes que têm sido implicados como responsáveis pelos sintomas. Visto que a estratégia terapêutica é geralmente baseada nos sintomas predominantes e sua gravidade, é importante reconhecer os mecanismos subjacentes para aliviar com sucesso a dor visceral e a alteração dos hábitos intestinais. O objetivo desta revisão literária não sistemática consistiu em explorar a fisiopatologia e opções terapêuticas disponíveis para a síndrome do intestino irritável, realçando a evidência mais recente, desde os novos critérios Roma IV até ao novo arsenal farmacológico.

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Section: Laboratory Testsmentioning

confidence: 99%

Irritable Bowel Syndrome: News from an Old Disorder

Ferreira

Garrido

Castro-Poças

2019

GE Port J Gastroenterol

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“…This is especially true for celiac disease, a common immune enteropathy of the small intestine[1], and the even more common functional intestinal disorders, which can also manifest with dyspepsia, bloating, abdominal pain, constipation or diarrhea[2]. The advent of serologic testing for celiac disease facilitated wider screening and it was soon recognized that celiac disease may be more common among patients diagnosed with irritable bowel syndrome (IBS) than among the general population[3] and may be increased in other functional GI disorders, such as functional dyspepsia (FD)[4]. …”

Section: Introductionmentioning

confidence: 99%

Symptoms of Functional Intestinal Disorders Are Common in Patients with Celiac Disease Following Transition to a Gluten-Free Diet

Silvester

Graff

Rigaux³

et al. 2017

Dig Dis Sci

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Background Celiac disease and functional intestinal disorders may overlap, yet the natural history of functional symptoms in patients with celiac disease is unknown. Aim To investigate the prevalence of irritable bowel syndrome (IBS), functional dyspepsia (FD) and functional bloating (FB) symptoms among patients with celiac disease at diagnosis and during the first year of a gluten-free diet. Methods Adults with a new diagnosis of celiac disease were surveyed at baseline, 6 months and 1 year using standardized measures for intestinal symptoms [Rome III diagnostic questionnaire and Celiac Symptom Index (CSI)] and gluten-free diet adherence [Gluten-Free Eating Assessment Tool (GF-EAT) and Celiac Diet Adherence Test (CDAT)]. Results At diagnosis, two-thirds fulfilled Rome III diagnostic questionnaire symptom criteria for IBS (52%), functional dyspepsia (27%) and/or functional bloating (9%). One year post-diagnosis, there was high adherence to a gluten-free diet as 93% reported gluten exposure less than once per month on the GF-EAT and only 8% had ongoing celiac disease symptoms (CSI score > 45). The rates of those meeting IBS (22%) and functional dyspepsia (8%) symptom criteria both decreased significantly on a gluten-free diet. The prevalence of functional symptoms (any of IBS, FD or FB) at 1 year was 47%. Conclusions Long-term follow-up of patients with celiac disease is necessary because many patients with celiac disease who are adherent to a gluten-free diet have persistent gastrointestinal symptoms.

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“…Instead, we relied on the fact that people who met the Rome IV criteria were likely to have IBS as a cause of their lower gastrointestinal symptoms. This may mean that we included some people with organic diseases such as celiac disease or inflammatory bowel disease,[54][55][56] rather than true IBS, although as the prevalence of these conditions in the community is much lower than IBS, this is unlikely to have had any major impact on our results. Although this is a limitation, our methodology is similar to that used in numerous population-based studies that have estimated the prevalence of IBS in community subjects,2 and even studies examining yield of colonoscopy in patients meeting criteria for IBS in secondary care report a low prevalence of organic disease 57,58.…”

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confidence: 99%

Anxiety‐related factors associated with symptom severity in irritable bowel syndrome

Black

Yiannakou

Houghton

et al. 2020

Neurogastroenterology Motil

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Background Gastrointestinal symptom‐specific anxiety and somatization have both been associated with higher symptom severity in patients with irritable bowel syndrome (IBS); however, this relationship has not been explored fully. Moreover, the performance of the visceral sensitivity index (VSI) for measuring gastrointestinal symptom‐specific anxiety has not been examined in a UK population. We conducted a cross‐sectional survey to examine these issues. Methods Gastrointestinal symptom‐specific anxiety was measured using the VSI, and somatization was measured via the patient health questionnaire‐12 (PHQ‐12) in adults from the UK community with Rome IV‐defined IBS. Exploratory factor analysis was performed on the VSI, prior to subsequent analyses, to establish its factor structure. Multiple regression analysis was used to determine the relationship between demographic features, different factors of the VSI, somatization, and IBS symptom severity. Key Results A total of 811 individuals with IBS provided complete data. Factor analysis of the VSI revealed a three‐factor structure, accounting for 47% of the variance. The first of these VSI factors and the PHQ‐12 were both strongly and independently associated with IBS symptom severity, for the group as a whole and for all four IBS subtypes. Most VSI items concerned with overt gastrointestinal symptom‐specific anxiety loaded onto the other two VSI factors that were not associated with symptom severity. Conclusions and Inferences The factor structure of the VSI requires further investigation. Our findings cast doubt on the central role of gastrointestinal symptom‐specific anxiety as a driver for symptom severity in IBS. Awareness of both gastrointestinal and extra‐intestinal symptoms, however, is strongly associated with symptom severity.

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Screening for Celiac Disease in Irritable Bowel Syndrome: An Updated Systematic Review and Meta-analysis

Cited by 131 publications

References 68 publications

Irritable Bowel Syndrome: News from an Old Disorder

Irritable Bowel Syndrome: News from an Old Disorder

Symptoms of Functional Intestinal Disorders Are Common in Patients with Celiac Disease Following Transition to a Gluten-Free Diet

Anxiety‐related factors associated with symptom severity in irritable bowel syndrome

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