title: Prevalence of irritable bowel syndrome-type symptoms in patients with celiac disease: a meta-analysis.
abstract: OBJECTIVE
  Patients with celiac disease (CD) often report symptoms compatible with irritable bowel syndrome (IBS). However, the prevalence of these symptoms in patients with CD and their relation to adherence to a gluten-free diet (GFD) have not been assessed systematically.
  
  
  METHODS
  We searched MEDLINE, EMBASE, and EMBASE Classic (through July 2012) to identify cross-sectional surveys or case-control studies reporting prevalence of IBS-type symptoms in adult patients (≥ 16 years old) with established CD. The number of individuals with symptoms meeting criteria for IBS was extracted for each study, according to case or control status and adherence to a GFD. Pooled prevalence and odds ratios (ORs), with 95% confidence intervals (CIs), were calculated. We analyzed data from 7 studies with 3383 participants.
  
  
  RESULTS
  The pooled prevalence of IBS-type symptoms in all patients with CD was 38.0% (95% CI, 27.0%-50.0%). The pooled OR for IBS-type symptoms was higher in patients with CD than in controls (5.60; 95% CI, 3.23-9.70). In patients who were nonadherent with a GFD, the pooled OR for IBS-type symptoms, compared with those who were strictly adherent, was 2.69 (95% CI, 0.75-9.56). There was also a trend toward a higher OR for IBS-type symptoms among patients who did not adhere to the GFD, compared with controls (12.42; 95% CI, 6.84-11.75), compared with that observed for adherent CD patients vs controls (4.28; 95% CI, 1.56-11.75).
  
  
  CONCLUSIONS
  IBS-type symptoms occur frequently in patients with CD and are more common than among controls. Adherence to a GFD might be associated with a reduction in symptoms.
authors.affiliation: Leeds Gastroenterology Institute, St James's University Hospital, Leeds, United Kingdom. anitabansal@yahoo.com
authors.forename: Anita
authors.initials: A
authors.lastname: Sainsbury
authors.forename: David S
authors.initials: DS
authors.lastname: Sanders
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Ford
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002446:Celiac Disease / Q000150:complications* / Q000628:therapy*; D055050:Diet, Gluten-Free; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology* / Q000473:pathology*; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult