Department of Gastroenterology, Ankara University Medical School, Ankara, Turkey.
Eur J Intern Med. 2010 Oct;21(5):389-92. doi: 10.1016/j.ejim.2010.06.004. Epub 2010 Jul 14.
Celiac disease shares several symptoms which constitute some of the ROME criteria used for the diagnosis of irritable bowel syndrome (IBS), and as such many patients with underlying Celiac disease may be mistakenly diagnosed as having IBS. The aim of the present study was to determine the prevalence of Celiac disease in patients with IBS fulfilling ROME III criteria.
Patients who fulfilled ROME III criteria for irritable bowel syndrome were screened for Celiac disease using the Biocard(TM) Celiac Disease Stick test, and patients who tested positive had their serum samples analyzed for antigliadin IgA and IgG, and anti-tissue transglutaminase IgA antibodies. Patients with detectable antibody levels underwent endoscopic duodenal biopsy to confirm a diagnosis of Celiac disease.
Two of 100 patients who were diagnosed as having irritable bowel syndrome as per the Roma III criteria were found to have elevated levels of serum antigliadin IgA and IgG, and anti-tissue transglutaminase IgA antibodies, with histological evidence of Celiac disease on examination of duodenal biopsy. Both patients were started on a gluten-free diet, showing significant improvement in their symptoms on follow-up.
Celiac disease is a common finding among patients labeled as IBS. Celiac disease must be considered in differential diagnosis of IBS especially in the therapy refractory group.
乳糜泻与一些罗马 III 标准中用于诊断肠易激综合征（IBS）的症状相同，因此许多患有潜在乳糜泻的患者可能会被误诊为 IBS。本研究的目的是确定符合罗马 III 标准的 IBS 患者中乳糜泻的患病率。
使用 Biocard（TM）乳糜泻棒检测试剂盒筛查符合罗马 III 标准的肠易激综合征患者的乳糜泻，对检测呈阳性的患者分析血清抗麦胶蛋白 IgA 和 IgG 以及抗组织转谷氨酰胺酶 IgA 抗体。检测到抗体水平的患者进行内镜十二指肠活检以确诊乳糜泻。
根据罗马 III 标准诊断为肠易激综合征的 100 例患者中，有 2 例患者血清抗麦胶蛋白 IgA 和 IgG 以及抗组织转谷氨酰胺酶 IgA 抗体水平升高，经十二指肠活检检查发现有乳糜泻的组织学证据。这两例患者均开始接受无麸质饮食治疗，随访时症状明显改善。
乳糜泻在被标记为 IBS 的患者中很常见。在 IBS 的鉴别诊断中必须考虑乳糜泻，尤其是在治疗抵抗的患者中。
