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Rice, Chilis, GERD and IBS
Irritable Bowel Syndrome (IBS) is characterized by chronic symptoms of abdominal pain, bloating, and constipation or diarrhea (or both). As many as 15% of people in the United States suffer from this disorder, which is treated both with medications and also with dietary adjustments.
Non-celiac gluten sensitivity: does it exist?
There's been a fair amount of coverage in the health news on recent research into non-celiac gluten sensitivity (NCGS). A study that appeared to confirm the existence of NCGS was refuted by a later study, performed by the same team. Their conclusion was that despite their earlier research, they could find no evidence that non-celiac gluten sensitivity exists.
Celiac Disease and GERD
The symptoms of Celiac Disease can range from none at all to diarrhea, stomach pain and bloating, and even acid reflux and other symptoms of gastroesophageal reflux disease (GERD). As you know, the only treatment for Celiac Disease is a gluten-free diet. Not long ago a group of researchers in Naples published a study that looked at whether a gluten-free diet would resolve the GERD-related symptoms in those with Celiac Disease (J Gastr and Hep 2008;23:1368-1372).
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We don't know exactly what causes Irritable Bowel Syndrome (IBS). Those with IBS often have stomach pain, bloating and diarrhea, and their symptoms come and go: people with IBS can go for some time without symptoms and then have flare-ups. The guidelines that doctors use to diagnose IBS vary from country to country and even professional association to professional association. Most guidelines do not recommend blood tests or expensive procedures like taking samples of the small intestine for testing; instead most doctors rely on their knowledge of the symptoms of IBS for a diagnosis.
Celiac Disease is an allergy to gluten, which is in wheat, rye and barley. Eating foods containing gluten causes changes to the lining of the small intestine, which reduces the sufferer's ability to absorb nutrients and leads to symptoms like stomach pain, bloating and diarrhea. Those with Celiac Disease who go on a gluten-free diet are usually freed from all symptoms, and in fact are healthier because they are able to properly absorb the nutrients they consume.
In a study recently published in the Archives of Internal Medicine, researchers pooled the results of a number of different studies to see if those with Irritable Bowel Syndrome might well have Celiac Disease (2009;169(7):651-658).
A total of over 4200 people in 14 studies were included in the research. Of those 4200 people, almost 2300 had been diagnosed with IBS and were offered blood or stomach biopsy tests to look for Celiac Disease. Compared to those people without Irritable Bowel Syndrome-like symptoms, those who did have IBS symptoms were four times as likely to have Celiac Disease that was diagnosed through blood tests followed by an intestinal biopsy.
The researchers note that their findings are important because undiagnosed Celiac Disease can contribute to such long-term effects as osteoporosis (bone loss), a higher risk of non-Hodgkin lymphoma, infertility or multiple miscarriages, and Vitamin D deficiency.
The average amount of time it takes to get a diagnosis of Celiac Disease is 12 months. If you or someone you know has Irritable Bowel Syndrome, insist that your doctor do the appropriate blood tests to check for gluten allergies. It can't hurt - and it may mean not only feeling better, but being healthier in the long run.
First posted: June 3, 2009