Am J Gastroenterol. 2012 Dec;107(12):1908-12. doi: 10.1038/ajg.2012.344.
Historically, it has been reported that patients with undetected celiac disease (CD) may present with irritable bowel syndrome (IBS) type symptoms. This has led to the recommendation by the American College of Gastroenterology Task force that patients presenting with diarrhea predominant IBS type symptoms should be serologically tested for CD. Concurrently speculative media data suggest that the US general public have increased their uptake of a gluten-free diet (GFD) far in excess of the known prevalence of CD. This may suggest that individuals with gastrointestinal symptoms are deriving benefit from a GFD even if they do not have CD. This has led to the scientific community considering the evidence for an emerging concept of non-celiac wheat sensitivity. There is a significant disparity in our views about what this phenomenon may be. There is also confusion about the nomenclature for this entity and indeed whether patients are suffering due to symptoms related to gluten or perhaps other components of wheat, for example fructans. In this month's edition of the American Journal of Gastroenterology, we see evidence to support the clinical concept of wheat sensitivity or intolerance. Irrespective of the nomenclature Carroccio provides a clinically applicable approach that may be adopted internationally by clinicians. This offers a new option in our armamentarium when seeing patients with IBS type symptoms.
从历史上看，据报道，未被发现的乳糜泻（CD）患者可能会出现肠易激综合征（IBS）型症状。这导致美国胃肠病学会工作组建议，出现以腹泻为主的 IBS 型症状的患者应进行乳糜泻的血清学检测。同时，推测性的媒体数据表明，美国公众对无麸质饮食（GFD）的接受度大大超过了已知的 CD 患病率。这可能表明，即使没有 CD，有胃肠道症状的个体也能从 GFD 中获益。这导致科学界考虑到非乳糜泻小麦敏感性这一新兴概念的证据。我们对这种现象可能是什么有很大的分歧。对于这个实体的命名法也存在混淆，甚至对于患者是否因为与麸质相关的症状而受苦，或者是否因为小麦的其他成分，例如果聚糖而受苦也存在混淆。在本月的《美国胃肠病学杂志》上，我们看到了支持小麦敏感性或不耐受临床概念的证据。无论命名如何，Carroccio 提供了一种临床适用的方法，可能被国际临床医生采用。这为我们治疗 IBS 型症状的患者提供了一个新的选择。
