Is it reasonable to perform serological tests for celiac disease in patients with irritable bowel syndrome?

Introduction: Both the irritable bowel syndrome (IBS) and celiac disease (CD) are diseases whose incidence has increased significantly over the past several decades. Growing body of evidence suggests that in some IBS patients, the undiagnosed celiac disease can be the cause of their symptoms.

Aim: To determine the prevalence of gluten intolerance and celiac disease types in patients with irritable bowel syndrome.

Material and methods: The study was conducted among gastroenterological surgery patients with irritable bowel syndrome diagnosed based on Rome II criteria treated in the Gastroenterology Clinic of Regional Brodnowski Hospital in Warsaw. One hundred and fifty IBS subjects were randomly selected for serological tests – in each patient, serum IgA autoantibodies against tissue transglutaminase (anti-tTG) and gliadin (AGAs) concentration were determined. These tests were also performed among 50 healthy subjects who served as the control group. In 20 patients with positive serological tests results for celiac disease the duodenoscopy with duodenal mucosa biopsy was performed.

Results: The incidence of positive serological test results for celiac disease was significantly higher in IBS patients compared to healthy control (32 vs. 0, p < 0.001). Duodenal mucosa histology in all patients who agreed to duodenoscopy (n = 20) was normal.

Conclusions: In IBS patients, gluten intolerance occurs significantly more often than in the general population, so it is advisable to perform serological tests for celiac disease in these patients. The most common celiac disease form in persons with IBS is the latent.