title: Non-Celiac Gluten Sensitivity Has Narrowed the Spectrum of Irritable Bowel Syndrome: A Double-Blind Randomized Placebo-Controlled Trial.
abstract: Several studies have shown that a large number of patients who are fulfilling the criteria for irritable bowel syndrome (IBS) are sensitive to gluten. The aim of this study was to evaluate the effect of a gluten-free diet on gastrointestinal symptoms in patients with IBS. In this double-blind randomized, placebo-controlled trial, 148 IBS patients fulfilling the Rome III criteria were enrolled between 2011 and 2013. However, only 72 out of the 148 commenced on a gluten-free diet for up to six weeks and completed the study; clinical symptoms were recorded biweekly using a standard visual analogue scale (VAS). In the second stage after six weeks, patients whose symptoms improved to an acceptable level were randomly divided into two groups; patients either received packages containing powdered gluten (35 cases) or patients received placebo (gluten free powder) (37 cases). Overall, the symptomatic improvement was statistically different in the gluten-containing group compared with placebo group in 9 (25.7%), and 31 (83.8%) patients respectively (p < 0.001). A large number of patients labelled as irritable bowel syndrome are sensitive to gluten. Using the term of IBS can therefore be misleading and may deviate and postpone the application of an effective and well-targeted treatment strategy in gluten sensitive patients.
authors.affiliation: Gastroenterology Unit, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran 5715915199, Iran. bijan.shahbaz@gmail.com.|Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran 1599666615, Iran. bijan.shahbaz@gmail.com.|Sasan Alborz Biomedical Research Center, Masoud Gastroenterology and Hepatology Clinic, Tehran 14117-13135, Iran. bijan.shahbaz@gmail.com.
authors.forename: Bijan
authors.initials: B
authors.lastname: Shahbazkhani
authors.affiliation: Gastroenterology Unit, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran 5715915199, Iran. dr.a_sadeghi@yahoo.com.
authors.forename: Amirsaeid
authors.initials: A
authors.lastname: Sadeghi
authors.affiliation: Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran 1599666615, Iran. dr.reza.malekzadeh@gmail.com.|Sasan Alborz Biomedical Research Center, Masoud Gastroenterology and Hepatology Clinic, Tehran 14117-13135, Iran. dr.reza.malekzadeh@gmail.com.
authors.forename: Reza
authors.initials: R
authors.lastname: Malekzadeh
authors.affiliation: Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran 1449614535, Iran. hototo24@yahoo.com.
authors.forename: Fatima
authors.initials: F
authors.lastname: Khatavi
authors.affiliation: Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran 1449614535, Iran. Mehr_etemadi@yahoo.com.
authors.forename: Mehrnoosh
authors.initials: M
authors.lastname: Etemadi
authors.affiliation: Gholhak Medical Laboratory, Tehran 1913913948, Iran. Kalantri@yahoo.com.
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Kalantri
authors.affiliation: Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran 1985714711, Iran. m.rostamii@gmail.com.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Rostami-Nejad
authors.affiliation: Department of Gastroenterology, Alexandra Hospital, Worcestershire B98 7UB, UK. kamran.rostami@nhs.net.
authors.forename: Kamran
authors.initials: K
authors.lastname: Rostami
mesh_terms: D000328:Adult; D002446:Celiac Disease; D055050:Diet, Gluten-Free; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005983:Glutens / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007492:Iran; D043183:Irritable Bowel Syndrome / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D016896:Treatment Outcome; D064232:Visual Analog Scale
chemical_list: D005983:Glutens
keywords: IBS; gluten free diet; non-celiac gluten sensitivity