title: The prevalence of coeliac disease in patients fulfilling Rome III criteria for irritable bowel syndrome.
abstract: OBJECTIVE
  The clinical presentation of coeliac disease can vary from a classical malabsorption syndrome to more subtle atypical gastrointestinal manifestations similar to irritable bowel syndrome (IBS). The aim of this study was to investigate the prevalence of coeliac disease in Egyptian patients with clinically diagnosed diarrhoea-predominant IBS (according to Rome III criteria).
  
  
  METHODS
  This study was conducted on 100 patients with clinically diagnosed diarrhoea-predominant IBS (fulfilling Rome III criteria). They were subjected to complete clinical evaluation, routine laboratory investigations, abdominal ultrasonography and serum anti-tissue transglutaminase antibody (anti-tTG) test as a predictor marker for coeliac disease. All patients who tested positive for serum anti-tTG underwent upper gastrointestinal endoscopy with four to eight biopsy samples collected from the second part of the duodenum.
  
  
  RESULTS
  All of the studied 100 patients presented with abdominal pain or discomfort, flatulence and diarrhoea. Eight patients (8%) exhibited high levels of serum anti-tTG, and their duodenal biopsy samples satisfied the histopathological criteria of coeliac disease. The studied patients were divided into two groups: Group I comprising 92 patients with IBS and negative anti-tTG results and Group II comprising eight patients with IBS and positive anti-tTG results. A non-significant difference was noted between the two groups in age, gender and duration of abdominal pain (p>0.05). The haemoglobin level was found to be significantly reduced in anti-tTG-positive patients (p<0.01), as was the Na level in anti-tTG-negative patients (p<0.05). A highly statistically significant inverse correlation was noted between anti-tTG and both serum total protein and serum albumin.
  
  
  CONCLUSIONS
  Some symptoms overlap between coeliac disease and IBS. A lack of awareness may lead to a diagnostic delay in these patients.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Sayed A
authors.initials: SA
authors.lastname: Shalaby
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Moataz M
authors.initials: MM
authors.lastname: Sayed
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Wesam A
authors.initials: WA
authors.lastname: Ibrahim
authors.affiliation: Department of Tropical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Electronic address: saratropical@yahoo.com.
authors.forename: Sara M
authors.initials: SM
authors.lastname: Abdelhakam
authors.affiliation: Department of Clinical and Chemical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
authors.forename: Marwa
authors.initials: M
authors.lastname: Rushdy
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D001706:Biopsy; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis* / Q000473:pathology*; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000209:etiology; D004386:Duodenum / Q000473:pathology*; D004534:Egypt / Q000453:epidemiology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005414:Flatulence / Q000209:etiology; D019204:GTP-Binding Proteins / Q000276:immunology*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011897:Random Allocation; D012709:Serum Albumin / Q000378:metabolism; D012964:Sodium / Q000097:blood; D011503:Transglutaminases / Q000276:immunology*; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D006454:Hemoglobins; D012709:Serum Albumin; D012964:Sodium; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins
keywords: Coeliac disease; Irritable bowel syndrome; Prevalence; Serum anti-tissue transglutaminase antibody