Gastroenteorlogy Unit, Brotzu Hospital, 09121 Cagliari, Italy.
Gastroenterology Unit, University of Cagliari, 09042 Monserrato, Italy.
Nutrients. 2018 Nov 7;10(11):1705. doi: 10.3390/nu10111705.
There is evidence that digestive motor disorders are frequently present in untreated celiac disease (CD) patients. Similarly, non-celiac gluten sensitivity (NCGS) can be associated with gut motor disorders. In both cases, gut dysmotility can improve or be completely reversed with a gluten-free diet (GFD). A literature search for motility disorders in CD and NCGS patients was carried out using the online databases PubMed, Medline and Cochrane. Esophageal, gastric, small bowel and gallbladder motor disorders are common in both children and adults with CD. Although the clinical consequences of these disorders are not clearly defined, gastric dysfunction could affect drug absorption and metabolism in the thyroid and neurological conditions associated with CD. The impact of a GFD on motility disorders is, however, controversial. No systematic studies are available on NCGS. NCGS frequently overlaps with irritable bowel syndrome (IBS) and similar pathophysiological mechanisms may be hypothesized. Mucosal damage may affect gut motility in untreated CD through perturbation of hormonal and neuro-immunomodulatory regulation. A persistent low-grade mucosal inflammation could explain the cases of persistent motor disorders despite a GFD. Further studies are needed to definitely assess the role of gut motor disorders in NCGS.
有证据表明，未经治疗的乳糜泻（CD）患者常存在消化运动障碍。同样，非乳糜泻麸质敏感性（NCGS）也可与肠道运动障碍相关。在这两种情况下，无麸质饮食（GFD）均可改善或完全逆转肠道运动障碍。使用在线数据库 PubMed、Medline 和 Cochrane 对 CD 和 NCGS 患者的运动障碍进行了文献检索。食管、胃、小肠和胆囊运动障碍在 CD 的儿童和成人中均很常见。尽管这些疾病的临床后果尚未明确界定，但胃功能障碍可能会影响甲状腺和与 CD 相关的神经状况下的药物吸收和代谢。然而，GFD 对运动障碍的影响存在争议。目前尚无关于 NCGS 的系统研究。NCGS 常与肠易激综合征（IBS）重叠，可能假设存在类似的病理生理机制。未治疗的 CD 中黏膜损伤可能通过扰乱激素和神经免疫调节来影响肠道运动。持续存在的低级别黏膜炎症可能解释了尽管进行了 GFD 但仍存在持续运动障碍的情况。需要进一步的研究来明确评估肠道运动障碍在 NCGS 中的作用。
