Plain language summary
Irritable bowel syndrome (IBS) is a condition that has a wide spectrum of symptoms and severity. This spectrum is narrowing due to advances in diagnostic tools and a better understanding of the etiologies of the disease. Recent studies have found that patients diagnosed with IBS may have specific food sensitivities that could relieve IBS-related symptoms. The aim of this trial was to evaluate the efficacy of a gluten-free diet on reducing the symptoms in patients with IBS. Clinical symptoms of 72 participants were measured for six weeks of either being on a gluten-free diet or gluten-containing diet. The findings of this study showed that a large number of patients with IBS are sensitive to gluten and their symptoms could be controlled with a gluten-free diet. Based on this study, the authors’ conclusions suggest that using the term of IBS can be misleading and that food sensitivities should be the first approach.
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.
Methodological quality
Allocation concealment
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