Researchers from Sheffield, England, assessed the association of celiac disease with irritable bowel syndrome (IBS) in patients fulfilling ROME II criteria.
They undertook a case-control study at a university hospital, in which 300 consecutive new patients who fulfilled Rome II criteria for IBS, and 300 healthy controls were enrolled.
All were investigated for celiac disease by analysis of serum IgA antigliadin, IgG antigliadin, and endomysial antibodies (EMA).
Patients and controls with positive antibody results were offered duodenal biopsy to confirm the possibility of celiac disease.
| IBS is significantly associated with celiac disease.
The team found that 66 patients with IBS had positive antibody results. Of these, 14 had celiac disease (11 EMA-positive, 3 EMA-negative).
Some 9 patients with positive antibody results were lost to follow-up or refused biopsy (only 1 EMA-positive patient refused biopsy), and 43 had normal duodenal mucosa.
Two controls, both of whom were EMA-positive, were found to have celiac disease.
Compared with matched controls, IBS was significantly associated with celiac disease (odds ratio = 7·0).
Dr David S. Sanders, of the Royal Hallamshire Hospital, Sheffield, concluded on behalf of his colleagues, "Patients with IBS referred to secondary care should be investigated routinely for celiac disease. With only EMA, 3 of 14 cases would have been missed."