门诊消化内镜中心患者自述的非腹腔麸质敏感性：高频率但医疗方法不足。
Self-reported nonceliac wheat sensitivity in an outpatient digestive endoscopy center: high frequency but insufficient medical approach.
机构信息
Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), Unit of Internal Medicine, University of Palermo.
Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), Unit of Gastroenterology, University of Palermo.
出版信息
Eur J Gastroenterol Hepatol. 2021 Dec 1;33(1S Suppl 1):e789-e795. doi: 10.1097/MEG.0000000000002257.
OBJECTIVE
'Self-reported wheat sensitivity' (SRWS) is a self-reported condition caused by wheat ingestion in the absence of celiac disease or wheat allergy. The aim of the study was to investigate the frequency and characteristics of SRWS in outpatients referred for digestive endoscopy.
METHODS
The study, performed at the University of Palermo, enrolled 496 outpatients.
RESULTS
Seven individuals (1.4%) had an already established diagnosis of celiac disease. The questionnaire was administered to the other 489 individuals: 98 subjects (20%) were SRWS, the remaining 391 served as controls (i.e. not-SRWS). SRWS patients were younger (P < 0.001), with a higher percentage of females (P = 0.002) than not-SRWS. 'gastroesophageal reflux disease and ulcer-like dyspepsia' and 'chronic unexplained diarrhea' were more frequently the reasons for the endoscopy study in SRWS than in not-SRWS (P = 0.002, and P = 0.05, respectively). Food allergies/intolerances (P = 0.04), milk allergy/intolerance (P = 0.0001), GERD (P = 0.0001), IBS (0.0001), anxiety (P = 0.005) and depression (P = 0.04) were the previous medical diagnoses reported more frequently in SRWS patients than in not-SRWS. In the SRWS group, 38% of the patients had already undergone previous upper endoscopy and 24% colonoscopy. After these investigations, 58% of SRWS patients received no diagnosis, and the other 42% were informed that they 'were not suffering from celiac disease or wheat allergy'. Finally, 28.6% SRWS patients had followed a gluten-free diet (GFD), and 71.4% of them referred being asymptomatic on GFD.
CONCLUSIONS
Our data showed a high frequency of SRWS in outpatients referred to a digestive endoscopy center and a lack of medical accuracy in identifying a possible gluten-related disease.
REGISTRATION
The study was registered on Clinicaltrials.gov (registration number: NCT04154137), accessible at: https://clinicaltrials.gov/ct2/show/NCT04154137?term=non+celiac+wheat&draw=2&rank=1.
目的
“自我报告的小麦敏感性”（SRWS）是一种在没有乳糜泻或小麦过敏的情况下因摄入小麦而引起的自我报告病症。本研究的目的是调查因消化内镜检查而就诊的门诊患者中 SRWS 的频率和特征。
方法
该研究在巴勒莫大学进行，共纳入 496 名门诊患者。
结果
7 人（1.4%）已确诊为乳糜泻。其余 489 名患者接受了问卷调查：98 名患者（20%）为 SRWS，其余 391 名患者为对照（即非-SRWS）。SRWS 患者更年轻（P<0.001），女性比例更高（P=0.002）。与非-SRWS 相比，SRWS 患者更常因“胃食管反流病和溃疡样消化不良”和“慢性不明原因腹泻”而接受内镜检查（P=0.002 和 P=0.05）。食物过敏/不耐受（P=0.04）、牛奶过敏/不耐受（P=0.0001）、GERD（P=0.0001）、IBS（0.0001）、焦虑（P=0.005）和抑郁（P=0.04）是 SRWS 患者比非-SRWS 患者更常报告的既往医学诊断。在 SRWS 组中，38%的患者已接受过先前的上消化道内镜检查，24%的患者接受过结肠镜检查。在这些检查后，58%的 SRWS 患者未得到诊断，而其余 42%的患者被告知他们“未患乳糜泻或小麦过敏”。最后，28.6%的 SRWS 患者遵循了无麸质饮食（GFD），其中 71.4%的患者自述在 GFD 后无症状。
结论
我们的数据显示，在因消化内镜检查而就诊的门诊患者中，SRWS 的发生率较高，而在识别可能与麸质相关的疾病方面缺乏医学准确性。
登记
该研究在 ClinicalTrials.gov 上注册（注册号：NCT04154137），可在以下网址获取：https://clinicaltrials.gov/ct2/show/NCT04154137?term=non+celiac+wheat&draw=2&rank=1。
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