Lab tests predict response to diet in patients with irritable bowel syndrome.
Comment: Previous studies have shown that gluten intolerance can occur in the absence of celiac disease. Symptoms that may result from gluten intolerance in non-celiac patients include aphthous ulcers, various neurological syndromes, and diarrhea or other gastrointestinal complaints. The results of the present study indicate that in a high proportion of patients with diarrhea-predominant irritable bowel syndrome, gluten intolerance is the main etiological factor. The study also showed that certain laboratory tests that are used to diagnose celiac disease can also predict which patients with diarrhea-predominant irritable bowel syndrome are most likely to respond to a gluten-free diet. However, since there were a number of false-positives and false-negatives associated with these tests, a therapeutic trial of a gluten-free diet is still the most reliable way to determine who is going to benefit. In my experience, patients who are going to improve on such a diet almost always see results in three weeks or less, so a longer-term elimination diet is rarely necessary. Wheat is by far the most common symptom-evoking gluten grain. Barley and rye are less likely to cause symptoms, and the vast majority of gluten-sensitive individuals seem to tolerate oats.
Wahnschaffe U, et al. Predictors of clinical response to gluten-free diet in patients diagnosed with diarrhea-predominant irritable bowel syndrome. Clin Gastroenterol Hepatol. 2007;5:844-850.
by Alan R. Gaby, MD
|Printer friendly Cite/link Email Feedback|
|Title Annotation:||Literature Review & Commentary|
|Author:||Gaby, Alan R.|
|Date:||Jan 1, 2008|
|Previous Article:||Muscadine grapes inhibit prostate cancer cells.|
|Next Article:||Fish really is "brain food".|