Long-Term Effect of a Gluten-Free Diet on Diarrhoea- or Bloating-Predominant Functional Bowel Disease: Role of the 'Low-Grade Coeliac Score' and the 'Coeliac Lymphogram' in the Response Rate to the Diet

Overview

Journal Nutrients

Date 2021 Jun 2

PMID 34073569

Citations 6

Authors

Fernando Fernandez-Banares

Beatriz Arau

Agnes Raga

Montserrat Aceituno

Eva Tristan

Anna Carrasco

Laura Ruiz

Albert Martin-Cardona

Pablo Ruiz-Ramirez

Maria Esteve

Affiliations

Soon will be listed here.

Abstract

Background: The long-term effect of a gluten-free diet (GFD) on functional bowel disorders (FBDs) has been scarcely studied. The aim was to assess the effect of a GFD on FBD patients, and to assess the role of both the low-grade coeliac score and coeliac lymphogram in the probability of response to a GFD. 2.

Methods: 116 adult patients with either predominant diarrhoea or abdominal bloating, fulfilling Rome IV criteria of FBD, were treated with a GFD. Duodenum biopsies were performed for both pathology studies and intraepithelial lymphocyte subpopulation patterns. Coeliac lymphogram was defined as an increase in TCRγδ cells plus a decrease in CD3 cells. A low-grade coeliac score >10 was considered positive. 3.

Results: Sustained response to GFD was observed in 72 patients (62%) after a median of 21 months of follow-up, who presented more often with coeliac lymphogram (37.5 vs. 11.4%; = 0.02) and a score >10 (32 vs. 11.4%; = 0.027) compared to non-responders. The frequency of low-grade coeliac enteropathy was 19.8%. 4.

Conclusion: A GFD is effective in the long-term treatment of patients with previously unexplained chronic watery diarrhoea- or bloating-predominant symptoms fulfilling the criteria of FBD. The response rate was much higher in the subgroup of patients defined by the presence of both a positive low-grade coeliac score and coeliac lymphogram.

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Nonceliac gluten sensitivity.

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Intestinal and blood lymphograms as new diagnostic tests for celiac disease.

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