title: Clinical impact of a gluten-free diet on health-related quality of life in seven fibromyalgia syndrome patients with associated celiac disease.
abstract: BACKGROUND
  Celiac disease (CD) is an autoimmune disorder, characterized by the presence of gastrointestinal and multisystem symptoms, which occasionally mimic those of Irritable Bowel Syndrome (IBS) and Fibromyalgia Syndrome (FMS). To assess the effectiveness of a Gluten-Free Diet (GFD) in seven adult female screening-detected CD subjects, categorized as severe IBS and FMS patients.
  
  
  METHODS
  All subjects showed villous atrophy in duodenal biopsies, were HLA-DQ2/DQ8-positive, and fulfilled the Rome III and ACR 1990 criteria respectively for IBS and FMS classification. GFD effectiveness was assessed at baseline and after 1 year, examining the score changes in the Tender Points (TPs) test, Fibromyalgia Impact Questionnaire (FIQ), Health Assessment Questionnaire (HAQ), Short Form Health Survey (SF-36), Visual Analogue Scales (VAS) for gastrointestinal complaints, pain and tiredness, drug prescriptions and tissue-Trans-Glutaminase (tTG) serum levels.
  
  
  RESULTS
  At baseline, all patients had poor Quality of Life and VAS scores, a high number of TPs and drug prescriptions, and increased tTG levels. After 1 year of GFD, all outcome measures significantly improved, with a decrease of 51-60% in TPs, FIQ, HAQ, and VAS scales, and in the number of prescribed drugs, accompanied by an increase of 48-60% in SF-36 Physical and Mental Component Summary scores, and a decrease of tTG to normal values.
  
  
  CONCLUSIONS
  Results of this pilot study show that the adherence to a GFD by CD-related IBS/FMS patients can simultaneously improve CD and IBS/FMS symptoms, and indicate the merit of further research on a larger cohort.
authors.affiliation: Gastroenterology, Central University Hospital of Asturias (HUCA), Celestino Villamil, s/n, 33006, Oviedo, Principality of Asturias, Spain. lrodrigosaez@gmail.com.
authors.forename: Luis
authors.initials: L
authors.lastname: Rodrigo
authors.forename: Ignacio
authors.initials: I
authors.lastname: Blanco
authors.forename: Julio
authors.initials: J
authors.lastname: Bobes
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: de Serres
mesh_terms: D000328:Adult; D000368:Aged; D002446:Celiac Disease / Q000150:complications / Q000178:diet therapy*; D055050:Diet, Gluten-Free; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000178:diet therapy*; D006304:Health Status; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000178:diet therapy*; D008875:Middle Aged; D010147:Pain Measurement; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome