Gastroenterology Unit, Brotzu Hospital, 09121 Cagliari, Italy.
Gastroenterology & Hepatology Section, Department of Medicine, University of Perugia, 06156 Perugia, Italy.
Nutrients. 2020 Apr 17;12(4):1117. doi: 10.3390/nu12041117.
: Irritable bowel syndrome (IBS) is frequently associated with celiac disease (CD) and nonceliac gluten/wheat sensitivity (NCGS/NCWS), but epidemiological and pathophysiological aspects are still unclear. Furthermore, a gluten-free diet (GFD) can positively influence IBS symptoms. : A comprehensive online search for IBS related to CD, NCGS and GFD was made using the Pubmed, Medline and Cochrane databases. : Although a systematic screening for CD in IBS is not recommended, CD prevalence can be increased in diarrhea-predominant IBS patients. On the other hand, IBS symptoms can be persistent in treated CD patients, and their prevalence tends to decrease on a GFD. IBS symptoms may overlap and be similar to those associated to nonceliac gluten and/or wheat sensitivity. Increased gut permeability could explain the gluten/wheat effects in IBS patients. Finally, a GFD could improve symptoms in a subgroup of IBS patients. : The possible interplay between IBS and gluten-related disorders represents a scientifically and clinically challenging issue. Further studies are needed to confirm these data and better clarify the involved pathophysiological mechanisms.
肠易激综合征(IBS)常与乳糜泻(CD)和非乳糜泻麸质/小麦敏感性(NCGS/NCWS)相关,但流行病学和病理生理学方面仍不清楚。此外,无麸质饮食(GFD)可对 IBS 症状产生积极影响。
我们使用 Pubmed、Medline 和 Cochrane 数据库对与 CD、NCGS 和 GFD 相关的 IBS 进行了全面的在线搜索。
虽然不建议对 IBS 进行系统性的 CD 筛查,但腹泻为主型 IBS 患者的 CD 患病率可能会增加。另一方面,治疗后的 CD 患者的 IBS 症状可能会持续存在,并且他们的患病率在 GFD 上趋于下降。IBS 症状可能与非乳糜泻麸质和/或小麦敏感性相关的症状重叠和相似。肠道通透性增加可以解释 IBS 患者中 gluten/wheat 的作用。最后,GFD 可以改善一部分 IBS 患者的症状。
IBS 和 gluten 相关疾病之间的可能相互作用是一个具有科学和临床挑战性的问题。需要进一步的研究来证实这些数据,并更好地阐明涉及的病理生理机制。