Evidence for existence of ‘non-celiac gluten intolerance’ uncovered
MedWire News: A small study has demonstrated that there may be some evidence for the existence of a non-celiac form of gluten intolerance.
Peter Gibson (Monash University, Victoria, Australia) and colleagues recruited 34 patients with irritable bowel syndrome (IBS), aged 29-59 years, in whom celiac disease had been excluded.
The participants were assigned to a gluten (n=19) or placebo (n=15) diet for up to 6 weeks. Patients in the gluten group received two bread slices and one muffin per day and those in the placebo group received a gluten-free equivalent.
The researchers assessed symptoms using a visual analog scale and also monitored markers of intestinal injury, immune activation, and inflammation.
They found that 13 (68%) patients in the gluten group versus six (40%) in the placebo group reported inadequately controlled IBS symptoms at 6 weeks.
Using the visual analog scale, patients in the gluten group had significantly worse scores after 1 week for overall symptoms, pain, bloating, satisfaction with stool consistency, and tiredness, compared with those in the placebo group.
Gibson and team found no significant differences in levels of anti-gliadin antibodies, fecal lactoferrin, celiac antibodies, or highly sensitive C-reactive protein between the two groups at study completion. Additionally, intestinal permeability did not change significantly in either group.
"No evidence for intestinal inflammation or damage, or for latent celiac disease was found to offer a mechanistic explanation for symptom deterioration caused by gluten," say the researchers.
"How common non-celiac gluten intolerance is, how it can be reliably identified, and what its underlying mechanisms are, warrant further evaluation," they conclude.
The results of this study are published in the American Journal of Gastroenterology.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Helen Albert