Celiac disease is uncommon in irritable bowel syndrome in the USA

Ann E. Almazar, Nicholas J. Talley, Joseph J. Larson, Elizabeth J. Atkinson, Joseph A Murray, Yuri Ann Saito Loftus

Research output: Contribution to journalArticle

Abstract

Background and aims Routine serologic testing for celiac disease (CD) may be useful in irritable bowel syndrome (IBS) patients, but this is controversial. We aimed to compare the prevalence of unrecognized CD in a large cohort of patients with and without IBS. Participants and methods This is a family case-control IBS study conducted at a single US academic medical center. Stored serum and DNA were available. Tissue transglutaminase (TTg) immunoglobulin A was performed, followed by indirect immunofluorescence testing for endomysial antibodies with positive or weakly positive TTg results. Individuals were considered to have CD if both results were positive. χ 2 and Fisher's exact tests were used to compare prevalence between the two groups. Results Serum samples were studied from 533 cases and 531 controls. In all, 80% of participants were female, with a median age of 50 years; 65% of cases and 0% controls met the Rome criteria for IBS. Previous serological testing for CD had occurred in 142 (27%) cases and 13 (2%) controls, but none had CD on subsequent testing. Six (1.1%) cases versus five (0.9%) controls had positive or weakly positive TTg test. Six cases (1.1%) versus three (0.6%) controls were confirmed to have CD by endomysial antibody (P=0.51). Conclusion No difference in the prevalence of CD between patients with IBS and patients without IBS at a tertiary medical center was observed. Our findings do not support routine celiac serologic or genetic testing in patients with IBS in all US populations.

Original languageEnglish (US)
Pages (from-to)149-154
Number of pages6
JournalEuropean Journal of Gastroenterology and Hepatology
Volume30
Issue number2
DOIs
StatePublished - Jan 1 2018

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Irritable Bowel Syndrome
Celiac Disease
Antibodies
Genetic Testing
Indirect Fluorescent Antibody Technique
Serum
Abdomen
Immunoglobulin A
DNA
Population
transglutaminase 2

Keywords

  • celiac disease
  • irritable bowel syndrome
  • screening serology

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Celiac disease is uncommon in irritable bowel syndrome in the USA. / Almazar, Ann E.; Talley, Nicholas J.; Larson, Joseph J.; Atkinson, Elizabeth J.; Murray, Joseph A; Saito Loftus, Yuri Ann.

In: European Journal of Gastroenterology and Hepatology, Vol. 30, No. 2, 01.01.2018, p. 149-154.

Research output: Contribution to journalArticle

Almazar, Ann E. ; Talley, Nicholas J. ; Larson, Joseph J. ; Atkinson, Elizabeth J. ; Murray, Joseph A ; Saito Loftus, Yuri Ann. / Celiac disease is uncommon in irritable bowel syndrome in the USA. In: European Journal of Gastroenterology and Hepatology. 2018 ; Vol. 30, No. 2. pp. 149-154.
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abstract = "Background and aims Routine serologic testing for celiac disease (CD) may be useful in irritable bowel syndrome (IBS) patients, but this is controversial. We aimed to compare the prevalence of unrecognized CD in a large cohort of patients with and without IBS. Participants and methods This is a family case-control IBS study conducted at a single US academic medical center. Stored serum and DNA were available. Tissue transglutaminase (TTg) immunoglobulin A was performed, followed by indirect immunofluorescence testing for endomysial antibodies with positive or weakly positive TTg results. Individuals were considered to have CD if both results were positive. χ 2 and Fisher's exact tests were used to compare prevalence between the two groups. Results Serum samples were studied from 533 cases and 531 controls. In all, 80{\%} of participants were female, with a median age of 50 years; 65{\%} of cases and 0{\%} controls met the Rome criteria for IBS. Previous serological testing for CD had occurred in 142 (27{\%}) cases and 13 (2{\%}) controls, but none had CD on subsequent testing. Six (1.1{\%}) cases versus five (0.9{\%}) controls had positive or weakly positive TTg test. Six cases (1.1{\%}) versus three (0.6{\%}) controls were confirmed to have CD by endomysial antibody (P=0.51). Conclusion No difference in the prevalence of CD between patients with IBS and patients without IBS at a tertiary medical center was observed. Our findings do not support routine celiac serologic or genetic testing in patients with IBS in all US populations.",
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