title: The effect of gluten on intestinal fermentation, gastric and gallbladder emptying in healthy volunteers.
abstract: BACKGROUND
  The relationship between gluten ingestion and gastrointestinal tract function is a matter of debate.
  
  
  OBJECTIVE
  We analysed the effect of gluten on gastric and gallbladder emptying and intestinal fermentation in healthy volunteers.
  
  
  METHODS
  Ultrasound measurement of gastric and gallbladder emptying after both gluten-containing and gluten-free meals was performed in 18 volunteers (8 women, age 25.0±2.5 years; BMI 22±1.9). Breath hydrogen excretion after a gluten-containing meal, a gluten-free meal and a gluten-free meal with added gluten powder was measured in 16 volunteers (10 women, age 25.2±2.7 years; BMI 22±1.8). The severity of symptoms was monitored.
  
  
  RESULTS
  Gluten presence in the meals was not recognised. Gastric emptying time was 81.6±13.8min after gluten-containing and 73.9±21.6min after gluten-free meals (p=0.11). Percentage ejection fraction after gluten-containing meals was 60±9% and 60.6±6% after gluten-free meals (p=0.68). Peak and cumulative hydrogen excretion were significantly higher after gluten-containing than after gluten-free meals (peak: 12.5±7.3 vs 6.5±5.1 parts-per-million, p<0.01; and cumulative: 2319±1720 vs 989±680 parts-per-million/minute, respectively; p<0.01). Adding gluten powder to the gluten-free meal did not modify fermentation. Symptoms were mild and not different after the meals.
  
  
  CONCLUSIONS
  In healthy volunteers, gluten may induce gastrointestinal alterations. Further studies are needed to clarify which patients could benefit from dietary modification.
authors.affiliation: 1st Department of Internal Medicine, University of Pavia, IRCCS "S. Matteo" Hospital Foundation, Pavia, Italy. Electronic address: m.distefano@unipv.it.
authors.forename: Michele
authors.initials: M
authors.lastname: Di Stefano
authors.affiliation: 1st Department of Internal Medicine, University of Pavia, IRCCS "S. Matteo" Hospital Foundation, Pavia, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Carnevale Maffè
authors.affiliation: 1st Department of Internal Medicine, University of Pavia, IRCCS "S. Matteo" Hospital Foundation, Pavia, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Bergonzi
authors.affiliation: 1st Department of Internal Medicine, University of Pavia, IRCCS "S. Matteo" Hospital Foundation, Pavia, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Mengoli
authors.affiliation: 1st Department of Internal Medicine, University of Pavia, IRCCS "S. Matteo" Hospital Foundation, Pavia, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Formagnana
authors.affiliation: 1st Department of Internal Medicine, University of Pavia, IRCCS "S. Matteo" Hospital Foundation, Pavia, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Di Sabatino
authors.affiliation: 1st Department of Internal Medicine, University of Pavia, IRCCS "S. Matteo" Hospital Foundation, Pavia, Italy.
authors.forename: Gino Roberto
authors.initials: GR
authors.lastname: Corazza
mesh_terms: D000328:Adult; D001944:Breath Tests; D055050:Diet, Gluten-Free; D005260:Female; D005285:Fermentation / Q000502:physiology*; D016473:Gallbladder Emptying / Q000502:physiology*; D005746:Gastric Emptying / Q000502:physiology*; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging*; D005983:Glutens / Q000008:administration & dosage*; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D005983:Glutens
keywords: Gallbladder emptying; Gastric emptying; Intestinal fermentation; Non-coeliac gluten sensitivity