Patients who met criteria for fibromyalgia and irritable bowel syndrome displayed clinical evidence of celiac disease that could contribute to their symptoms, according to recent research results.
Researchers studied 104 patients (mean age, 50 years; 89.4% women) who fulfilled 1990 American College of Rheumatology criteria for fibromyalgia syndrome (FMS) and Rome III criteria for irritable bowel syndrome (IBS) classification, along with 125 age- and sex-matched patients (mean age, 51 years; 84% women) with IBS but not FMS from an outpatient gastroenterology clinic in Spain. Hematological, coagulation and biochemistry tests were conducted, along with testing for serological and genetic markers for celiac disease (CD), multiple gastric and duodenal biopsies, FMS tender points, Fibromyalgia Impact Questionnaire, Health Assessment Questionnaire, Short Form (36) Health Survey and visual analog scales (VAS) for tiredness and gastrointestinal complaints.
Patients with IBS and FMS had much worse scores in values in quality of life and VAS compared with patients with IBS alone (P<.001). Major histocompatibility complex DQ2/DQ8 positivity, high TGt-2 serum levels and duodenal villous atrophy, which were in agreement with CD, were observed in seven IBS/FMS patients (6.7%). Almost 30% of IBS/FMS patients had a family history of CD. Once the patients began a gluten-free diet (GFD), they displayed improvement in digestive and systemic symptoms at follow-up.
“The findings of this case-finding study indicate that some of the misdiagnosed IBS/FMS cases could suffer from an underlying CD, which can contribute to the IBS and FMS symptoms, development and maintenance,” the researchers concluded. “[The patients] can improve symptoms and possibly prevent long-term, CD-related complications with a strict lifelong GFD.”
Disclosure: The researchers report no relevant financial disclosures.