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No Link Found Between Celiac Disease and Irritable Bowel Syndrome
In 1994 I was diagnosed with celiac disease, which led me to create Celiac.com in 1995. I created this site for a single purpose: To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives. Celiac.com was the first site on the Internet dedicated solely to celiac disease. In 1998 I foundedÂ The Gluten-Free Mall, Your Special Diet Superstore!, and I am the co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.View all articles by Scott Adams
Celiac.com 05/25/2004 - The results of a study conducted by Dr. G. Richard Locke III and colleagues at the Mayo Clinic College of Medicine in Rochester, Minnesota do not show an association between irritable bowel syndrome (IBS) and celiac disease. The case-control study was based on the respondents of a bowel disease questionnaire that was sent to random Olmsted County residents who were 20 to 50 years old. The researchers evaluated 150 subjects, 72 of whom reported having symptoms of IBS and dyspepsia, and 78 controls with no gastrointestinal symptoms. In the group with symptoms they found that 50 had IBS, 24 had dyspepsia and 15 had both conditions. Serological screening of both groups for celiac disease showed no significant difference between them—two controls, two IBS subjects and two people with dyspepsia tested positive for celiac disease. The researchers conclude that celiac disease alone cannot explain the presence or IBS or dyspepsia in the subjects.
The results of this study are interesting, but probably
not large enough to be statistically significant. The total number of
people with celiac disease in each group was astounding:
2 out of 50 with IBS (4%)
2 out of 24 with dyspepsia (6%)
2 of the 78 controls (2.6%)
These findings do not necessarily contradict previous IBS/CD studies that looked at hospital outpatients who are more likely to have more severe and prolonged symptoms than a group that selects itself from the general public by responding to a questionnaire. Additionally most of the earlier studies that concluded that there was a connection between celiac disease and IBS were conducted before more recent epidemiological studies that have shown just how high the incidence of celiac disease in the general population is--now estimated between 0.8% and 1.3%--this study suggests 2 -3%. These recent epidemiological studies have also shown that a large percentage of celiacs have little or no symptoms, perhaps due to the length of time or the severity of the disease.
A 1 in 20 diagnosis of celiac disease in patients with IBS/dyspepsia is consistent with other studies, and is still high and suggests that testing for celiac disease should be done routinely on these patients. No studies have ever suggested that all or even most IBS patients have celiac disease, just that the incidence is higher than that of the normal population.
I propose that if this study had been done on exactly the same people several years from now, the 2 people in the control group who were found to have celiac disease may well develop symptoms that would put them in either the IBS or dyspepsia group, which would create a statistically significant result that would contradict this studys result. Last, perhaps the results of this study really support a more broad conclusion: Everyone ought to be screened for celiac disease, not just those with symptoms.
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Gender and Mental Health are Factors in Irritable Bowel Disease-related Symptoms in Celiac Disease
In the majority of people with celiac disease,
strict adherence to a gluten-free diet can result in a quality of life
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Screening Irritable Bowel Syndrome Patients for Celiac Disease Found to be Cost Effective
Aliment Pharmacol Ther 19(11):1199-1210, 2004.... [READ MORE]
Excerpts on the Association of Irritable Bowel Syndrome and Celiac Disease by Laura Yick
The Canadian Medical Association Journal (Hoey, 2002;166:479-80) published
the following, Irritable Bowel Syndrome: Could it be Celiac Disease?,
as excerpted below.... [READ MORE]
At Least 4.6% of People Diagnosed With Irritable Bowel Syndrome Have Undetected Celiac Disease
Lancet Nov 2001
Volume 358, Number 9292 1504-08 03
Celiac.... [READ MORE]