Non-celiac Gluten Sensitivity Rates Not Higher for Fibromyalgia Patients

Celiac.com 09/19/2022 - A team of researchers recently set out to calculate rates of non-coeliac gluten sensitivity (NCGS) in a group of fibromyalgia patients, to evaluate their clinical response to a six-week gluten-free diet, any improvement in symptoms, rates of diet responders who did not meet non-coeliac gluten sensitivity diagnostic criteria, and any baseline characteristics associated with diet response and diagnostic criteria fulfillment.

The research team included Miriam Almirall, Francesc Casellas, Joan Dot, Inés de Torres, Hegoi Segurola, Sara Marsal. They are variously affiliated with the Department of Pathology, Department of Endoscopy, Department of Rheumatology, and the Nutritional Support Unit ant the Hospital Universitari Vall d’Hebron, Barcelona, Spain; the Rheumatology Research Group, Vall d’Hebron Research Institute; the Digestive System Research Unit Gastroenterology; and the Department of Morphological Sciences, Autonomous University of Barcelona.

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The team carried out an uncontrolled prospective experimental study in a group of patients with fibromyalgia from a specialized hospital ward. 

The team analyzed the percentage of patients who met the Salerno Experts’ Criteria, responded to a gluten-free diet, improved their symptomatology and baseline characteristics, and met diagnostic criteria.

In all, the team found a non-coeliac gluten sensitivity rate of about 6% in 142 patients. About 22% of those showed an improvement in intestinal symptoms on a gluten-free diet. 

In total, 74.2% of the responders did not fulfil the Salerno Experts’ Criteria. The presence of diarrhea and intraepithelial lymphocytosis and lower levels of anxiety were predictive factors of gluten-free diet response. No predictive factors of non-coeliac gluten sensitivity criteria fulfilment were found due to the low number of discriminators between gluten and placebo.

These results show that patients with fibromyalgia have non-coeliac gluten sensitivity at rates similar to the general population. That means a gluten-free diet won't be appropriate for all patients with fibromyalgia. However, it could be useful for patients with diarrhea or intraepithelial lymphocytosis, at least to assess any improvement in intestinal symptoms.

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