Celiac disease is uncommon in irritable bowel syndrome in the USA

Almazar AE1, Talley NJ1,2, Larson JJ3, Atkinson EJ3, Murray JA1,4, Saito YA1. Eur J Gastroenterol Hepatol. 2017 Dec 12. doi: 10.1097/MEG.0000000000001022. [Epub ahead of print]
Author information

1 Department of Medicine, Division of Gastroenterology and Hepatology.

2 Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia.

3 Department of Health, Division of Biomedical Statistics and Informatics.

4 Department of Immunology, Mayo Clinic, Rochester, Minnesota, USA.


BACKGROUND AND AIMS: Routine serologic testing for celiac disease (CD) may be useful in irritable bowel syndrome (IBS) patients, but this is controversial. We aimed to compare the prevalence of unrecognized CD in a large cohort of patients with and without IBS.

PARTICIPANTS AND METHODS: This is a family case-control IBS study conducted at a single US academic medical center. Stored serum and DNA were available. Tissue transglutaminase (TTg) immunoglobulin A was performed, followed by indirect immunofluorescence testing for endomysial antibodies with positive or weakly positive TTg results. Individuals were considered to have CD if both results were positive. χ and Fisher's exact tests were used to compare prevalence between the two groups.

RESULTS: Serum samples were studied from 533 cases and 531 controls. In all, 80% of participants were female, with a median age of 50 years; 65% of cases and 0% controls met the Rome criteria for IBS. Previous serological testing for CD had occurred in 142 (27%) cases and 13 (2%) controls, but none had CD on subsequent testing. Six (1.1%) cases versus five (0.9%) controls had positive or weakly positive TTg test. Six cases (1.1%) versus three (0.6%) controls were confirmed to have CD by endomysial antibody (P=0.51).

CONCLUSION: No difference in the prevalence of CD between patients with IBS and patients without IBS at a tertiary medical center was observed. Our findings do not support routine celiac serologic or genetic testing in patients with IBS in all US populations.

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