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News

Patients who avoid wheat or gluten in the absence of celiac disease

A study in this month's issue of Digestive Diseases and Sciences examines the characteristics of patients who avoid wheat and/or gluten in the absence of celiac disease.

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Gastrointestinal symptoms that respond to the removal of wheat and/or gluten are becoming more common.

Patients who avoid wheat and/or gluten are a heterogeneous group and predominantly self-diagnosed prior to presenting for clinical evaluation.

Dr Anna Tavakkoli and colleagues characterized patients who avoid wheat and/or gluten seen at a tertiary care referral center, and compared them to patients with celiac disease, and subjects in the National Health and Nutrition examination survey (NHANES).

The team performed a cross-sectional study evaluating patients seen by 4 gastroenterologists at a celiac disease referral center.

Baseline characteristics, laboratory values, and medical comorbidities were compared to celiac disease patients who presented at the same center and subjects enrolled in NHANES.
32 alternative diagnoses were made in 30% of patients  
Digestive Diseases & Sciences

The researchers identified 84 patients who avoid wheat and/or gluten compared to 585 celiac disease patients and 2,686 NHANES patients.

The team noted that 32 alternative diagnoses were made in 30% of patients who avoid wheat and/or gluten, including small intestinal bacterial overgrowth and fructose/lactose intolerance.

When compared to patients with celiac disease, patients who avoid wheat and/or gluten had similar body mass index, and mean hemoglobin value.

The team observed that when compared to male and female patients in NHANES, BMI, folate, and mean hemoglobin values were lower in patients who avoid wheat and/or gluten.

Both male and female patients who avoid wheat and/or gluten had a lower prevalence of hypertension.

Dr Tavakkoli's team concludes, "While there are similarities between celiac disease and patients who avoid wheat and/or gluten that could possibly be due to shared HLA haplotypes or an effect of the gluten-free diet, alternative diagnoses are common in these patients."

"Patients who avoid wheat and/or gluten have a similar cardiovascular profile as celiac disease patients in terms of lower BMI and lower prevalence of hypertension."

Dig Dis Sci 2014: 59(6): 1255-1261
20 June 2014

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