Intestinal Research

Pravir A Gambhire

1 Article

Symptomatic improvement with gluten restriction in irritable bowel syndrome: a prospective, randomized, double blinded placebo controlled trial: Vinay G Zanwar, Sunil V Pawar, Pravir A Gambhire, Samit S Jain, Ravindra G Surude, Vinaya B Shah, Qais Q Contractor, Pravin M Rathi; Intest Res 2016;14(4):343-350. Published online October 17, 2016; DOI: https://doi.org/10.5217/ir.2016.14.4.343

<b>Background/Aims</b><br/>

The existence of non-celiac gluten sensitivity has been debated. Indeed, the intestinal and extra-intestinal symptoms of many patients with irritable bowel syndrome (IBS) but without celiac disease or wheat allergy have been shown to improve on a gluten-free diet. Therefore, this study set out to evaluate the effects of gluten on IBS symptoms.

Methods

We performed a double-blind randomized placebo-controlled rechallenge trial in a tertiary care hospital with IBS patients who fulfilled the Rome III criteria. Patients with celiac disease and wheat allergy were appropriately excluded. The participants were administered a gluten-free diet for 4 weeks and were asked to complete a symptom-based questionnaire to assess their overall symptoms, abdominal pain, bloating, wind, and tiredness on the visual analog scale (0-100) at the baseline and every week thereafter. The participants who showed improvement were randomly assigned to one of two groups to receive either a placebo (gluten-free breads) or gluten (whole cereal breads) as a rechallenge for the next 4 weeks.

Results

In line with the protocol analysis, 60 patients completed the study. The overall symptom score on the visual analog scale was significantly different between the two groups (P<0.05). Moreover, the patients in the gluten intervention group scored significantly higher in terms of abdominal pain, bloating, and tiredness (P<0.05), and their symptoms worsened within 1 week of the rechallenge.

Conclusions

A gluten diet may worsen the symptoms of IBS patients. Therefore, some form of gluten sensitivity other than celiac disease exists in some of them, and patients with IBS may benefit from gluten restrictions.

Citations

Citations to this article as recorded by

Gluten-free grains: Importance, processing and its effect on quality of gluten-free products
Samandeep Kaur, Kshitiz Kumar, Lochan Singh, Vijay Singh Sharanagat, Prabhat K. Nema, Vijendra Mishra, Bharat Bhushan
Critical Reviews in Food Science and Nutrition.2024; 64(7): 1988. CrossRef
Indian consensus statements on irritable bowel syndrome in adults: A guideline by the Indian Neurogastroenterology and Motility Association and jointly supported by the Indian Society of Gastroenterology
Uday C. Ghoshal, Sanjeev Sachdeva, Nitesh Pratap, Arun Karyampudi, Uzma Mustafa, Philip Abraham, Chetan B. Bhatt, Karmabir Chakravartty, Sujit Chaudhuri, Omesh Goyal, Govind K. Makharia, Manas Kumar Panigrahi, Prasanta Kumar Parida, Sudhanshu Patwari, Raj
Indian Journal of Gastroenterology.2023; 42(2): 249. CrossRef
Current evidence for dietary therapies in irritable bowel syndrome
Anupam Rej, Hugo A. Penny
Current Opinion in Gastroenterology.2023; 39(3): 219. CrossRef
The Role of Gluten in Gastrointestinal Disorders: A Review
Sabrina Cenni, Veronica Sesenna, Giulia Boiardi, Marianna Casertano, Giuseppina Russo, Alfonso Reginelli, Susanna Esposito, Caterina Strisciuglio
Nutrients.2023; 15(7): 1615. CrossRef
Gluten restriction in irritable bowel syndrome, yes or no?: a GRADE-assessed systematic review and meta-analysis
Erfan Arabpour, Dorsa Alijanzadeh, Amir Sadeghi, Sina Khoshdel, Azita Hekmatdoost, Hamed Kord-Varkaneh, Mohammad Abdehagh
Frontiers in Nutrition.2023;[Epub] CrossRef
Boosting biomedical document classification through the use of domain entity recognizers and semantic ontologies for document representation: The case of gluten bibliome
Martín Pérez-Pérez, Tânia Ferreira, Anália Lourenço, Gilberto Igrejas, Florentino Fdez-Riverola
Neurocomputing.2022; 484: 223. CrossRef
Management of bloating
Jordi Serra
Neurogastroenterology & Motility.2022;[Epub] CrossRef
Evidence-Based and Emerging Diet Recommendations for Small Bowel Disorders
Anupam Rej, Michael D. E. Potter, Nicholas J. Talley, Ayesha Shah, Gerald Holtmann, David Surendran Sanders
American Journal of Gastroenterology.2022; 117(6): 958. CrossRef
Diet and irritable bowel syndrome: an update from a UK consensus meeting
A. Rej, A. Avery, I. Aziz, C. J. Black, R. K. Bowyer, R. L. Buckle, L. Seamark, C. C. Shaw, J. Thompson, N. Trott, M. Williams, D. S. Sanders
BMC Medicine.2022;[Epub] CrossRef
Belgian consensus on irritable bowel syndrome
S Kindt, H Louis, H De Schepper, J Arts, P Caenepeel, D De Looze, A Gerkens, T Holvoet, P Latour, T Mahler, F Mokaddem, S Nullens, H Piessevaux, P Poortmans, G Rasschaert, M Surmont, H Vafa, K Van Malderen, T Vanuytsel, F Wuestenberghs, J Tack
Acta Gastro Enterologica Belgica.2022; 85(2): 360. CrossRef
A food pyramid, based on a review of the emerging literature, for subjects with inflammatory bowel disease
Mariangela Rondanelli, Silvia Lamburghini, Milena A. Faliva, Gabriella Peroni, Antonella Riva, Pietro Allegrini, Daniele Spadaccini, Clara Gasparri, Giancarlo Iannello, Vittoria Infantino, Tariq A. Alalwan, Simone Perna, Alessandra Miccono
Endocrinología, Diabetes y Nutrición.2021; 68(1): 17. CrossRef
Non-responsive celiac disease may coincide with additional food intolerance/malabsorption, including histamine intolerance
Wolfgang J. Schnedl, Harald Mangge, Michael Schenk, Dietmar Enko
Medical Hypotheses.2021; 146: 110404. CrossRef
Non-celiac wheat sensitivity: rationality and irrationality of a gluten-free diet in individuals affected with non-celiac disease: a review
Consolato Sergi, Vincenzo Villanacci, Antonio Carroccio
BMC Gastroenterology.2021;[Epub] CrossRef
Personalizing Dietary Therapies For Irritable Bowel Syndrome: What Is Gluten’s Role?
Anupam Rej, Imran Aziz, David S. Sanders
Clinical Gastroenterology and Hepatology.2021; 19(11): 2270. CrossRef
A food pyramid, based on a review of the emerging literature, for subjects with inflammatory bowel disease
Mariangela Rondanelli, Silvia Lamburghini, Milena A. Faliva, Gabriella Peroni, Antonella Riva, Pietro Allegrini, Daniele Spadaccini, Clara Gasparri, Giancarlo Iannello, Vittoria Infantino, Tariq A. Alalwan, Simone Perna, Alessandra Miccono
Endocrinología, Diabetes y Nutrición (English ed.).2021; 68(1): 17. CrossRef
Histamine Intolerance Originates in the Gut
Wolfgang J. Schnedl, Dietmar Enko
Nutrients.2021; 13(4): 1262. CrossRef
Diarrhea Predominant-Irritable Bowel Syndrome (IBS-D): Effects of Different Nutritional Patterns on Intestinal Dysbiosis and Symptoms
Annamaria Altomare, Claudia Di Rosa, Elena Imperia, Sara Emerenziani, Michele Cicala, Michele Pier Luca Guarino
Nutrients.2021; 13(5): 1506. CrossRef
Adherence to treatment of patients with irritable bowel syndrome: state of the issue
S.A. Sukhanova, A.Yu. Timakova, M.A. Livzan, M.M. Fedorin, Yu.P. Skirdenko, O.V. Gaus, K.A. Andreev, A.V. Gorbenko, M.I. Plinder
Profilakticheskaya meditsina.2021; 24(8): 101. CrossRef
Update S3-Leitlinie Reizdarmsyndrom: Definition, Pathophysiologie, Diagnostik und Therapie. Gemeinsame Leitlinie der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) und der Deutschen Gesellschaft für Neurogastr
P. Layer, V. Andresen, H. Allescher, S. C. Bischoff, M. Claßen, S. Elsenbruch, M. Freitag, T. Frieling, M. Gebhard, M. Goebel-Stengel, W. Häuser, G. Holtmann, J. Keller, M. E. Kreis, W. Kruis, J. Langhorst, P. Lynen Jansen, A. Madisch, H. Mönnikes, S. Mül
Zeitschrift für Gastroenterologie.2021; 59(12): 1323. CrossRef
Nutrition in Patients with Lactose Malabsorption, Celiac Disease, and Related Disorders
Michele J. Alkalay
Nutrients.2021; 14(1): 2. CrossRef
Letter: the gluten‐free diet as a bottom‐up approach for irritable bowel syndrome
Anupam Rej, Rachel Louise Buckle, Christian Charles Shaw, Nick Trott, Imran Aziz, David Surendran Sanders
Alimentary Pharmacology & Therapeutics.2020; 51(1): 184. CrossRef
Irritable Bowel Syndrome and Gluten-Related Disorders
Paolo Usai-Satta, Gabrio Bassotti, Massimo Bellini, Francesco Oppia, Mariantonia Lai, Francesco Cabras
Nutrients.2020; 12(4): 1117. CrossRef
Ernährungsmedizinische Aspekte beim Reizdarmsyndrom – ein Update
Larissa Hetterich, Andreas Stengel
Aktuelle Ernährungsmedizin.2020; 45(04): 276. CrossRef
The Two Faces of Wheat
Herbert Wieser, Peter Koehler, Katharina A. Scherf
Frontiers in Nutrition.2020;[Epub] CrossRef
Low Fermentable Oligo- Di- and Mono-Saccharides and Polyols (FODMAPs) or Gluten Free Diet: What Is Best for Irritable Bowel Syndrome?
Massimo Bellini, Sara Tonarelli, Maria Gloria Mumolo, Francesco Bronzini, Andrea Pancetti, Lorenzo Bertani, Francesco Costa, Angelo Ricchiuti, Nicola de Bortoli, Santino Marchi, Alessandra Rossi
Nutrients.2020; 12(11): 3368. CrossRef
Breaking bread!
Anupam Rej, Imran Aziz, David Surendran Sanders
Proceedings of the Nutrition Society.2019; 78(1): 118. CrossRef
Efficacy of the gluten free diet in the management of functional gastrointestinal disorders: a systematic review on behalf of the Italian Society of Paediatrics
Elena Scarpato, Renata Auricchio, Francesca Penagini, Angelo Campanozzi, Gian Vincenzo Zuccotti, Riccardo Troncone
Italian Journal of Pediatrics.2019;[Epub] CrossRef
The overlap of irritable bowel syndrome and noncoeliac gluten sensitivity
Anupam Rej, David S. Sanders
Current Opinion in Gastroenterology.2019; 35(3): 199. CrossRef
Gluten Vehicle and Placebo for Non-Celiac Gluten Sensitivity Assessment
Oscar Gerardo Figueroa-Salcido, Noé Ontiveros, Francisco Cabrera-Chavez
Medicina.2019; 55(5): 117. CrossRef
The role of diet in irritable bowel syndrome: implications for dietary advice
A. Rej, I. Aziz, H. Tornblom, D. S. Sanders, M. Simrén
Journal of Internal Medicine.2019; 286(5): 490. CrossRef
Does Irritable Bowel Syndrome Exist? Identifiable and Treatable Causes of Associated Symptoms Suggest It May Not
Benjamin I. Brown
Gastrointestinal Disorders.2019; 1(3): 314. CrossRef
Extra-intestinal manifestations of non-celiac gluten sensitivity: An expanding paradigm
Giuseppe Losurdo, Mariabeatrice Principi, Andrea Iannone, Annacinzia Amoruso, Enzo Ierardi, Alfredo Di Leo, Michele Barone
World Journal of Gastroenterology.2018; 24(14): 1521. CrossRef
Is an enzyme supplement for celiac disease finally on the cards?
Julia König, Robert J. Brummer
Expert Review of Gastroenterology & Hepatology.2018; 12(6): 531. CrossRef
Non-celiac gluten sensitivity: people without celiac disease avoiding gluten—is it due to histamine intolerance?
Wolfgang J. Schnedl, Sonja Lackner, Dietmar Enko, Michael Schenk, Harald Mangge, Sandra J. Holasek
Inflammation Research.2018; 67(4): 279. CrossRef
Gluten sensitivities and the allergist: Threshing the grain from the husks
J. G. Burkhardt, A. Chapa‐Rodriguez, S. L. Bahna
Allergy.2018; 73(7): 1359. CrossRef
Prevalence and factors associated with gluten sensitivity in inflammatory bowel disease
Berkeley N. Limketkai, Rachel Sepulveda, Tressia Hing, Neha D. Shah, Monica Choe, David Limsui, Shamita Shah
Scandinavian Journal of Gastroenterology.2018; 53(2): 147. CrossRef
Non‐celiac gluten or wheat sensitivity: It's complicated!
Maria I. Pinto‐Sanchez, Elena F. Verdu
Neurogastroenterology & Motility.2018;[Epub] CrossRef
Canadian packaged gluten-free foods are less nutritious than their regular gluten-containing counterparts
Jennifer A. Jamieson, Mary Weir, Laura Gougeon
PeerJ.2018; 6: e5875. CrossRef
Consensus document on exclusion diets in irritable bowel syndrome (IBS)
Francesc Casellas, Rosa Burgos, Ascensión Marcos, Javier Santos, Constanza Ciriza de los Ríos, Álvaro García Manzanares, Isabel Polanco, María Puy Portillo, Antonio Villarino, Beatriz Lema Marqués, María del Carmen Vázquez Alférez
Revista Española de Enfermedades Digestivas.2018;[Epub] CrossRef
Gluten-Free Diet and Its ‘Cousins’ in Irritable Bowel Syndrome
Anupam Rej, David Surendran Sanders
Nutrients.2018; 10(11): 1727. CrossRef
IRRITABLE BOWEL SYNDROME, FOOD INTOLERANCE AND NON- CELIAC GLUTEN SENSITIVITY. A NEW CLINICAL CHALLENGE
Rosa Leonôra Salerno SOARES
Arquivos de Gastroenterologia.2018; 55(4): 417. CrossRef
Randomized clinical trial: Effective gluten degradation by Aspergillus niger-derived enzyme in a complex meal setting
Julia König, Savanne Holster, Maaike J. Bruins, Robert J. Brummer
Scientific Reports.2017;[Epub] CrossRef
The Overlapping Area of Non-Celiac Gluten Sensitivity (NCGS) and Wheat-Sensitive Irritable Bowel Syndrome (IBS): An Update
Carlo Catassi, Armin Alaedini, Christian Bojarski, Bruno Bonaz, Gerd Bouma, Antonio Carroccio, Gemma Castillejo, Laura De Magistris, Walburga Dieterich, Diana Di Liberto, Luca Elli, Alessio Fasano, Marios Hadjivassiliou, Matthew Kurien, Elena Lionetti, Ch
Nutrients.2017; 9(11): 1268. CrossRef
Irritable bowel syndrome and diet
Eirini Dimidi, Megan Rossi, Kevin Whelan
Current Opinion in Clinical Nutrition & Metabolic Care.2017; 20(6): 456. CrossRef
Diet in irritable bowel syndrome: What to recommend, not what to forbid to patients!
Anamaria Cozma-Petruţ, Felicia Loghin, Doina Miere, Dan Lucian Dumitraşcu
World Journal of Gastroenterology.2017; 23(21): 3771. CrossRef

7,797 View
105 Download
47 Web of Science
45 Crossref

Author index