23302 Can a Gluten-free Diet Reduce Symptoms of Irritable Bowel Syndrome? - Celiac.com
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Can a Gluten-free Diet Reduce Symptoms of Irritable Bowel Syndrome?

Celiac.com 06/14/2013 - A team of researchers recently conducted a controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea to gauge the effects on bowel frequency and intestinal function. Their goal was to determine whether a gluten-free diet might benefit patients with diarrhea-predominant irritable bowel syndrome (IBS-D).

Photo: Public Domain--WikicommonsThe team included M.I. Vazquez-Roque, M. Camilleri, T. Smyrk, J.A. Murray, E. Marietta, J. O'Neill, P. Carlson, J. Lamsam, D. Janzow, D. Eckert, D. Burton, A.R. Zinsmeister. They are variously affiliated with the Clinical Enteric Neuroscience Translational and Epidemiological Research at the Mayo Clinic in Rochester, Minnesota, and the Division of Gastroenterology and Hepatology at the Mayo Clinic in Jacksonville, Florida.

The team designed a randomized controlled 4-week trial comparing the effects of a gluten-containing diet against gluten-free diet in 45 patients with IBS-D.

They conducted genotype analysis for HLA-DQ2 and HLA-DQ8, and randomly placed twenty-two patients on the gluten-containing diet (11 HLA-DQ2/8 negative and 11 HLA-DQ2/8 positive) and 23 patients on the gluten-free diet (12 HLA-DQ2/8 negative and 11 HLA-DQ2/8 positive).

They measured daily bowel function, small-bowel and colonic transit. They used lactulose and mannitol excretion to measure mucosal permeability, and peripheral blood mononuclear cells after exposure to gluten and rice to gauge cytokine production.

The team collected rectosigmoid biopsy specimens from 28 patients, analyzed levels of messenger RNAs encoding tight junction proteins, and performed H&E staining and immunohistochemical analyses.

They analyzed covariance models to compare data from the gluten-containing and gluten-free diet groups.

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They found that subjects on the gluten-containing diet had more bowel movements per day (P = .04); the gluten-containing diet had a greater effect on bowel movements per day of HLA-DQ2/8-positive than HLA-DQ2/8-negative patients (P = .019).

They also found that the gluten-containing diet was associated with higher SB permeability, based on 0-2 h levels of mannitol and the ratio of lactulose to mannitol. They found that SB permeability to be greater in HLA-DQ2/8-positive than HLA-DQ2/8-negative patients (P = .018), and saw no significant differences in colonic permeability.

Patients on the gluten-containing diet had a small decrease in expression of zonula occludens 1 in SB mucosa and significant decreases in expression of zonula occludens 1, claudin-1, and occludin in rectosigmoid mucosa.

The effects of the gluten-containing diet on expression were substantially greater in HLA-DQ2/8-positive patients. Neither diet had any significant effects on transit or histology.

Peripheral blood mononuclear cells produced higher levels of interleukin-10, granulocyte colony-stimulating factor, and transforming growth factor-α in response to gluten than rice, regardless of HLA genotype.

The team's findings show that gluten alters bowel barrier functions in patients with IBS-D, especially in HLA-DQ2/8-positive patients, and that these aspects of IBS can be reversed with a gluten-free diet.

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6 Responses:

 
Stella
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said this on
17 Jun 2013 5:45:32 AM PDT
Could you please make a final point, in layman's term so a person can actually understand and determine if the gluten-free diet was helpful or not? While your information is detailed, it is not clear if it was indeed recommended for a person with IBS or not. Thank You!

 
Sheila
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said this on
20 Aug 2013 2:18:19 PM PDT
I agree, what the heck did this article say??? I have a serious case of IBS and I am wondering if I should go on a gluten-free diet.

 
Cindy
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said this on
17 Jun 2013 5:58:40 PM PDT
I have a friend with IBS so I am going to print this out and give it to her.

 
dappy
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said this on
18 Jun 2013 8:36:37 AM PDT
Didn't work for me. I had to begin a probiotic to get results even though I am totally gluten-free.

 
Julie
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said this on
18 Jun 2013 6:07:09 PM PDT
Just fyi, dappy, many people who've had diarrhea, short or long-term from any cause, need probiotics to help their digestive system get back to normal. Diarrhea sends the good bacteria out of your system - think of flushing the pipes. All of the good goes out with the rest. We have to re-establish good bacteria in the intestine.

I recently read of a study that pointed to having a large variety of bacteria seemed to be protective against developing celiac disease. The site doesn't allow links to be posted, but if you google "pubmed+Lower economic status and inferior hygienic environment may protect against celiac disease" you can read the study results.

 
sher
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said this on
19 Jun 2013 1:33:30 PM PDT
I have tried the probiotic and now gluten-free. I'm finding that my IBS reacts now if I eat something with gluten. The flareups are far worse with gluten as opposed to the gluten-free options.

My GP and Internist are hesitant to pursue celiac disease as my bloodwork shows no reactivity due to the sheer lack of gluten in my diet now. I am not prepared to start eating gluten just to re-confirm what I already have figured out.




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George, i am sorry that you are not feeling well! ?? I am not a doctor, but just trying out drugs to stop your symptoms just seems like a band aid approach. It sounds like he suspects IBS which is really, in my opinion, "I be stumped". Has inflammatory bowel disorder (IBD) (more lovely autoimmune disorders) been ruled out? This includes both Crohn's and Colitis. My niece was diagnosed with Crohn's finally with a pill camera after all other tests were given. The damage was not within reach of any scope. I am just throwing out suggestions. Hopefully, you and your doctor will figure it out soon!

Celiac disease is an autoimmune disease that happens to have a known trigger -- gluten. Flare-ups develop (antibodies) causing damage. Not just in the small intestine, but systemically. One gluten exposure can cause antibodies to increase for days or months! Antibodies are being measured during the celiac blood tests. If there is no gluten exposure, there will be no antibodies. These antibodies can come down in some people in as little as two weeks. Recommendations require gluten 2 to 4 weeks daily for the biopsies taken via endoscopy in order to be sure to catch damage, but 8 to 12 weeks for the blood tests. The endoscopy is considered the "gold standard" in helping to diagnose celiac disease, but there are other things that can damage the small intestine. So, the blood test helps solidify the diagnosis. So, if you want a good result on your endoscopy, you need to be eating gluten daily for two week prior at a minimum. I know it is tough and you are feeling sick. Wish there was a better way to catch active celiac disease.

Hi everyone, Just an update to my situation. I had thought that I might be getting better since I started adding gluten-free grain back into my diet but I was wrong. It seems that the Methscopalamine Bromide just delayed the effects, didn't stop them. I had to stop taking it because one of the side effects is to stop sweating, which I did. There were times when I felt hot and almost couldn't catch my breath. Anyway, my doc put me on Viberzi instead. I took 3 doses, 1 Tuesday evening and then 1 Wednesday morning and then again Wednesday evening. Each time I took 1, it seemed that about half an hour later I would develop severe abdominal cramping, pain in my neck, shoulders and upper back and a feeling like my insides were on fire. My face felt like it was hot and tingling. It wasn't warm to the touch but felt like it to me. Worse of all is it didn't work anyway, I still had diarrhea. I stopped taking Viberzi after reading the precautions pamphlet which said, "stop taking Viberzi and tell your doctor if you have abdominal cramping, pain which radiates to your shoulders or upper back." Go figure. Anyway, today is 3 weeks straight of diarrhea and still no diagnosis and not sure what he's going to want to do next. George

I'm still really new to all this but is it common to have trouble with sleep? I swear since my symptoms got really bad a few months ago I can't get 1 good nights sleep, like a 5 hour stretch is doing real good. Wake up at 3am wide awake almost every night. Told my doctor and they've recommended melatonin, that doesn't work. Tried chamomile and lavender tea, no help. Tried zzquil, that will knock me out but maybe for like an extra hour then I'm really drowsy the next morning from it. I don't know what to do.

I have 2 copies of DQ9. One from each parent.