Department of Gastroenterology, Hospital Universitari Mutua Terrassa, 08221 Terrassa, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 28029 Madrid, Spain.
Nutrients. 2021 May 26;13(6):1812. doi: 10.3390/nu13061812.
The long-term effect of a gluten-free diet (GFD) on functional bowel disorders (FBDs) has been scarcely studied. The aim was to assess the effect of a GFD on FBD patients, and to assess the role of both the low-grade coeliac score and coeliac lymphogram in the probability of response to a GFD. 2.
116 adult patients with either predominant diarrhoea or abdominal bloating, fulfilling Rome IV criteria of FBD, were treated with a GFD. Duodenum biopsies were performed for both pathology studies and intraepithelial lymphocyte subpopulation patterns. Coeliac lymphogram was defined as an increase in TCRγδ cells plus a decrease in CD3 cells. A low-grade coeliac score >10 was considered positive. 3.
Sustained response to GFD was observed in 72 patients (62%) after a median of 21 months of follow-up, who presented more often with coeliac lymphogram (37.5 vs. 11.4%; = 0.02) and a score >10 (32 vs. 11.4%; = 0.027) compared to non-responders. The frequency of low-grade coeliac enteropathy was 19.8%. 4.
A GFD is effective in the long-term treatment of patients with previously unexplained chronic watery diarrhoea- or bloating-predominant symptoms fulfilling the criteria of FBD. The response rate was much higher in the subgroup of patients defined by the presence of both a positive low-grade coeliac score and coeliac lymphogram.
无麸质饮食（GFD）对功能性肠病（FBD）的长期影响鲜有研究。本研究旨在评估GFD 对 FBD 患者的疗效，并评估低级别麸质评分和乳糜泻淋巴图在对 GFD 反应概率中的作用。2.
116 例成人患者以腹泻为主或腹胀为主，符合 FBD 的罗马 IV 标准，均接受 GFD 治疗。对十二指肠活检进行病理研究和上皮内淋巴细胞亚群分析。乳糜泻淋巴图定义为 TCRγδ 细胞增加和 CD3 细胞减少。低级别麸质评分>10 为阳性。3.
中位随访 21 个月后，72 例（62%）患者对 GFD 持续有反应，乳糜泻淋巴图（37.5%比 11.4%；=0.02）和评分>10（32%比 11.4%；=0.027）的患者更常见。低级别麸质肠病的发生率为 19.8%。4.
GFD 是治疗先前不明原因慢性水样腹泻或腹胀为主的 FBD 患者的有效方法。在低级别麸质评分和乳糜泻淋巴图均阳性的患者亚组中，反应率更高。
