Internal Medicine Unit, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90129, Palermo, Italy.
Gynecology Unit, Giovanni Paolo II Hospital, Sciacca, Italy.
Dig Dis Sci. 2021 Jan;66(1):167-174. doi: 10.1007/s10620-020-06184-8. Epub 2020 Mar 7.
Non-celiac wheat sensitivity (NCWS) most frequently presents clinically with irritable bowel syndrome (IBS)-like symptoms, although many extra-intestinal manifestations have also been attributed to it. No studies to date have evaluated the presence and frequency of gynecological symptoms in NCWS.
To evaluate the frequency of gynecological disorders in patients with NCWS.
Sixty-eight women with NCWS were included in the study. A questionnaire investigating gynecological symptoms and recurrent cystitis was administered, and patients reporting symptoms were then examined by specialists. Three control groups were selected: 52 patients with IBS not related to NCWS, 56 patients with celiac disease (CD), and 71 healthy controls.
59% of the patients with NCWS showed gynecological symptoms, a higher frequency than in healthy controls (P = 0.04), IBS controls (P = 0.01) and CD controls (P = 0.02). Menstrual cycle alterations were more frequent in patients with NCWS than in healthy controls (26.5% vs 11.3%; P = 0.03); the patients with NCWS suffered from recurrent vaginitis (16%) and dyspareunia (6%) significantly more frequently than healthy controls. Twenty-nine percent of patients with NCWS reported recurrent cystitis, a finding higher than in the control groups (vs healthy P = 0.0001, vs IBS P = 0.001, vs CD controls P = 0.04). Microbiological examinations were negative in most of the patients with NCWS and recurrent vaginitis or cystitis. During the 1-year follow-up, 46% of patients with menstrual disorders and 36% with recurrent vaginitis reported resolution of symptoms on a wheat-free diet.
Patients with NCWS showed a significantly higher frequency of gynecological symptoms and recurrent cystitis than patients with IBS.
非麸质小麦敏感（NCWS）最常表现为肠易激综合征（IBS）样症状，尽管也有许多肠外表现归因于它。迄今为止，尚无研究评估 NCWS 患者中妇科症状的存在和频率。
评估 NCWS 患者妇科疾病的频率。
本研究纳入了 68 例 NCWS 女性患者。进行了一项调查妇科症状和复发性膀胱炎的问卷，报告有症状的患者随后由专家检查。选择了三个对照组：52 例与 NCWS 无关的 IBS 患者、56 例乳糜泻（CD）患者和 71 例健康对照者。
59%的 NCWS 患者出现妇科症状，频率高于健康对照组（P=0.04）、IBS 对照组（P=0.01）和 CD 对照组（P=0.02）。NCWS 患者的月经周期改变较健康对照组更为常见（26.5%比 11.3%；P=0.03）；NCWS 患者复发性阴道炎（16%）和性交困难（6%）的发生率明显高于健康对照组。29%的 NCWS 患者报告复发性膀胱炎，这一发现高于对照组（与健康对照组相比，P=0.0001；与 IBS 对照组相比，P=0.001；与 CD 对照组相比，P=0.04）。大多数 NCWS 患者伴有复发性阴道炎或膀胱炎的微生物检查结果为阴性。在 1 年随访期间，46%的月经紊乱患者和 36%的复发性阴道炎患者报告在无麸质饮食后症状缓解。
与 IBS 患者相比，NCWS 患者妇科症状和复发性膀胱炎的发生率明显更高。
