title: Prevalence of celiac disease in Iranian patients with irritable bowel syndrome: a cross-sectional study.
abstract: OBJECTIVE
  This study was aimed to determine the prevalence of celiac disease (CD) in irritable bowel syndrome (IBS) and its subtypes in a group of Iranian patients.
  
  
  METHODS
  From March 2007 to June 2009, 465 consecutive patients who were referred to the gastroenterology clinic of Jundishapur University of Medical Sciences and fulfilled the Rome III criteria for IBS were included. Immunoglobulin A (IgA) anti-tissue transglutaminase (IgA-tTG) and anti-gliadin antibody (AGA) levels were measured. CD was confirmed by gastroduodenoscopy and biopsy in patients with abnormal antibodies.
  
  
  RESULTS
  Five patients had only elevated IgA-tTG, 26 with only elevated AGA, and in 16 patients abnormal results for both antibodies were reported. Duodenal biopsies from these 47 patients confirmed CD in 13 (2.8%, 95% CI 1.6-4.0%) according to the Marsh criteria. Two CD patients had normal IgA-tTG concentrations while only one patient with normal AGA was proven to have CD. CD was most prevalent in unsubtyped IBS (4.9%, 95% CI 1.1-8.7%), followed by mixed IBS (4.7%, 95% CI 0.3-9.1%). In multiple comparison, CD was less common in diarrhea-predominant IBS than in unsubtyped IBS, although this did not reach statistical significance (1.0% vs. 4.9%, P = 0.057).
  
  
  CONCLUSIONS
  CD in unsubtyped IBS had a growing trend to be more common than in diarrhea-predominant IBS. Evaluation of IBS patients for CD is advisable.
authors: Research Institute for Infectious Diseases of Digestive System, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors: Ali Akbar
authors: AA
authors: Shayesteh
authors: Eskandar
authors: E
authors: Hajiani
authors: Seyed Jalal
authors: SJ
authors: Hashemi
authors: Abdolrahim
authors: A
authors: Masjedizadeh
authors: Seyed Mahmod
authors: SM
authors: Latifi
authors: Mehdi
authors: M
authors: Shayesteh
mesh_terms: D000328:Adult; D002446:Celiac Disease / Q000453:epidemiology* / Q000276:immunology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007492:Iran / Q000453:epidemiology; D043183:Irritable Bowel Syndrome / Q000150:complications* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015995:Prevalence
chemical_list: D007070:Immunoglobulin A
keywords: Rome III criteria; anti-gliadin antibody; anti-tissue transglutaminase antibody; celiac disease; irritable bowel syndrome