Celiac disease serology in irritable bowel syndrome and dyspepsia: a population-based case-control study.
OBJECTIVE
To determine whether undiagnosed celiac disease is associated with irritable bowel syndrome (IBS) or dyspepsia in the community.


METHODS
A self-report bowel disease questionnaire was mailed to a random sample of Olmsted County, Minnesota, residents aged 20 to 50 years. All respondents who reported symptoms of dyspepsia or IBS (cases) and all respondents without notable gastrointestinal symptoms (controls) were invited to participate (260 eligible subjects; 150 [58%] were studied). Each respondent was examined by a physician, and the medical records of each were reviewed (3 subjects did not meet the criteria for dyspepsia or IBS at the time of the physician interview). Serum was obtained to measure antiendomysial antibodies and tissue transglutaminase (TTg) IgA antibodies using validated assays.


RESULTS
A total of 34 subjects had dyspepsia (20 had ulcerlike dyspepsia), 50 had IBS (19 had diarrhea-predominant IBS), and 15 met criteria for both dyspepsia and IBS; 78 were asymptomatic healthy controls. The overall prevalence of positive TTg serology was 4% (95% confidence interval [CI], 1.5%-8.5%). The number of subjects who were seropositive for TTg was 2 of 34 (5.9%) with dyspepsia (95% CI, 0.7%-19.7%), 2 of 50 (4.0%) with IBS (95% CI, 0.5%-13.7%), and 2 of 78 (2.6%) of asymptomatic controls (95% CI, 03%-9.0%) (P = .64 IBS vs controls; P = .58 dyspepsia vs controls). No subjects had positive antiendomysial antibodies.


CONCLUSIONS
In this community, celiac disease did not explain the presence of either IBS or dyspepsia.
Locke
G Richard
GR
Division of Gastroenterology and Hepatology and Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA. locke.giles@mayo.edu
Murray
Joseph A
JA
Zinsmeister
Alan R
AR
Melton
L Joseph
LJ
Talley
Nicholas J
NJ
D000328:Adult; D017677:Age Distribution; D016022:Case-Control Studies; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology / Q000378:metabolism; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000209:etiology; D004415:Dyspepsia / Q000209:etiology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D015983:Selection Bias; D016036:Seroepidemiologic Studies; D012698:Serologic Tests; D017678:Sex Distribution; D011795:Surveys and Questionnaires