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Prevalence of irritable bowel syndrome-type symptoms in patients with celiac disease: a meta-analysis

Sainsbury A, Sanders D & Ford A. Clin Gastroenterol Hepatol 2013;11:359–365.

Short summary

A high proportion of patients with coeliac disease (CD) experience symptoms similar to irritable bowel syndrome (IBS). 

Using data from cross-sectional surveys and case-control studies, the pooled prevalence of symptoms meeting the criteria for IBS in all patients with CD was 38% (95% CI, 27.0%–50.0%). Prevalence in individual studies varied from 20.0% to 58.4%, with statistically significant heterogeneity between studies (p<0.001). 

Using data from case-control studies, including 626 patients with CD and 1,995 controls without CD, the pooled odds ratio (OR) for IBS-type symptoms was signi´Čücantly higher in those with patients with CD compared with controls (5.60; 95% CI, 3.23–9.70). All studies included in the meta-analysis included adherence to a gluten-free diet (GFD); adherence ranged from 62% to 100%. The pooled odds ratio for IBS-type symptoms in patients that were non-adherent to a GFD was 2.69 (95% CI, 0.75–9.56). 

The pooled OR for IBS-type symptoms in CD patients adherent to a GFD, compared with controls without CD, was 4.28 (95% CI, 1.56–11.75). The pooled OR for symptoms compatible with IBS among CD patients nonadherent to a GFD, compared with controls without CD, was 12.42 (95% CI, 6.84–22.6).

IBS-type symptoms impact the quality of life of patients with CD and symptoms may improve by adopting a GFD. Additional work is required to increase the awareness among clinicians of the high prevalence of IBS-type symptoms in CD, which could lead to improvements in care and quality of life for patients with CD.

Job number: JB57410GBr Date of Preparation: June 2019

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