Sub-optimal gluten free diet adherence in coeliac disease: reinforcing the link between gut inflammation and irritable bowel syndrome?

Abstract

Introduction Symptoms consistent with the ROME Criteria for Irritable Bowel Syndrome (IBS) have been reported in patients with Coeliac Disease. Treatment for Coeliac Disease is a Gluten-Free Diet (GFD), which aims to dampen infl ammation, restore small bowel architecture and reduce symptoms. We questioned whether patients with less than, or no adherence to a GFD -and therefore, we assumed, active gut infl ammation -were more likely to report IBS type symptoms than patients with full adherence. We also recorded the prevalence of refl ux symptoms to determine whether small bowel infl ammation is specifi cally associated with IBS or symptoms of wider gut dysmotility. Methods 224 histologically proven Coeliac Disease patients (5% 18-25 years, 4% 26-35 years, 18% 36-45 years, 19% 46-55 years, 26% 56-65 years, 28% >66 years) of which 26% were male. Mean disease duration 8 years, range 0.5-52 years. The ROME II Criteria for IBS symptoms, a refl ux symptom