Original Article

The Epidemiological and Clinical Characteristics of Celiac Disease among Patients with Irritable Bowel Syndrome in Zanjan Province, Iran

Abstract

Background: There are some overlaps between celiac disease and irritable bowel syndrome symptoms (IBS). It can lead to misdiagnosis or delayed diagnosis of celiac disease. In some guidelines, it is recommended to screen for celiac in IBS cases. For assessment of the necessity for such diagnostic approaches in patients, this study was done to evaluate the epidemiological and clinical characteristics of celiac disease among IBS cases in Zanjan, Iran.

Methods: In this descriptive cross-sectional study, 121 cases with IBS attending to gastroenterology clinics since 2015 to 2018 were enrolled. The laboratory tests and upper digestive endoscopy were performed for all patients. Endoscopic biopsy specimens were taken from the duodenum, and the samples were examined to confirm diagnosis of celiac disease. Data analysis was done by SPSS software.

Results: Of 121 studied patients, 51.2% were male. The mean age of the patients was 36.65 ± 10.09 years old. The most common IBS subtype was mixed (80.2%). According to the serology results and Marsh grading, 4.1% and 1.6% had celiac disease and potential celiac disease, respectively. There were statistically significant differences among celiac disease in gastroesophageal reflux disease and abdominal discomfort/cramping.

Conclusion: The incidence of celiac disease was evaluated 4.1 cases per each 100 patients with IBS, which was higher than recent similar studies, and screening for celiac disease in these patients is advisable. However, further studies with larger sample size are required to attain more definite results.

 

1. Dapoigny M, Bellanger J, Bonaz B, et al. Irritable bowel syndrome in France: a common, debilitating and costly disorder. Eur J Gastroen Hepat. 2004;16(10):995-1001.
2. Brun-Strang C, Dapoigny M, Lafuma A, et al. Irritable bowel syndrome in France: quality of life, medical management, and costs: the Encoli study. Eur J Gastroen Hepat. 2007;19(12):1097-103.
3. Wilson S, Roberts L, Roalfe A, et al. Prevalence of irritable bowel syndrome: a community survey. Br J Gen Pract. 2004;54(504):495-502.
4. Pimentel M, Soffer EE, Chow EJ, et al. Lower frequency of MMC is found in IBS subjects with abnormal lactulose breath test, suggesting bacterial overgrowth. Digest Dis Sci. 2002;47(12):2639-43.
5. Everitt HA, Moss-Morris RE, Sibelli A, et al. Management of irritable bowel syndrome in primary care: feasibility randomised controlled trial of mebeverine, methylcellulose, placebo and a patient self-management cognitive behavioural therapy website.(MIBS trial). BMC gastroenterology. 2010;10(1):136.
6. Lee SY, Lee KJ, Kim SJ, Cho SW. Prevalence and risk factors for overlaps between gastroesophageal reflux disease, dyspepsia, and irritable bowel syndrome: a population-based study. Digestion. 2009;79(3):196-201.
7. Ford AC, Marwaha A, Lim A, Moayyedi P. Systematic review and meta-analysis of the prevalence of irritable bowel syndrome in individuals with dyspepsia. Clin Gastroenterol H. 2010;8(5):401-9.
8. AnJiang W, XianHua L, Xiong L, et al. The clinical overlap between functional dyspepsia and irritable bowel syndrome based on Rome III criteria. BMC gastroenterology. 2008;8(1):43.
9. Korkut E, Bektas M, Oztas E, et al. The prevalence of celiac disease in patients fulfilling Rome III criteria for irritable bowel syndrome. Eur J Intern Med. 2010;21(5):389-92.
10. Sharma H, Verma AK, Das P, et al. Prevalence of celiac disease in I ndian patients with irritable bowel syndrome and uninvestigated dyspepsia. J Dig Dis. 2015;16(8):443-8.
11. Shayesteh AA, Hajiani E, Hashemi SJ, et al. Prevalence of celiac disease in I ranian patients with irritable bowel syndrome: A cross‐sectional study. J Dig Dis. 2014;15(1):12-7.
12. Mohammadibakhsh R, Sohrabi R, Salemi M, et al. Celiac disease in Iran: a systematic review and meta-analysis. Electron Physician. 2017;9(3):3883.
13. Wang H, Zhou G, Luo L, et al. Serological screening for celiac disease in adult Chinese patients with diarrhea predominant irritable bowel syndrome. Medicine. 2015;94(42).
14. Sánchez‐Vargas L, Thomas‐Dupont P, Torres‐Aguilera M, et al. Prevalence of celiac disease and related antibodies in patients diagnosed with irritable bowel syndrome according to the Rome III criteria. A case–control study. Neurogastroent Motil. 2016;28(7):994-1000.
15. Azami M, Badfar G, Abangah G, Mahmoudi L. Celiac disease in Iranian irritable bowel syndrome patients; a systematic review and meta-analysis. Gastroenterol Hepatol Bed Bench. 2019;12(2):85.
16. Domżał-Magrowska D, Kowalski MK, Szcześniak P, et al. The prevalence of celiac disease in patients with irritable bowel syndrome and its subtypes. Przeglad gastroenterologiczny. 2016;11(4):276.
17. Almazar AE, Talley NJ, Brantner TL, et al. Celiac Disease is Uncommon in Irritable Bowel Syndrome in the United States. Eur J Gastroen Hepat. 2018;30(2):149.
18. Mahmoodi A, Jafarihaydarlo A, Yasemi M, et al. Celiac disease prevalence in the patients with irritable bowel syndrome in the ilam province; a cross sectional study from Western iran. J Clin Diagn Res. 2014;8(12):GC01.
19. Kibune-Nagasako C, García-Montes C, Silva-Lorena SL, Aparecida-Mesquita M. Irritable bowel syndrome subtypes: Clinical and psychological features, body mass index and comorbidities. Rev Esp Enferm Dig. 2016;108(2):59-64.
20. Quigley E, Bytzer P, Jones R, Mearin F. Irritable bowel syndrome: the burden and unmet needs in Europe. Digest Liver Dis. 2006;38(10):717-23.
21. Su A, Shih W, Presson AP, Chang L. Characterization of symptoms in irritable bowel syndrome with mixed bowel habit pattern. Neurogastroent Motil. 2014;26(1):36-45.
22. Lin S, Mooney PD, Kurien M, et al. Prevalence, investigational pathways and diagnostic outcomes in differing irritable bowel syndrome subtypes. Eur J Gastroen Hepat. 2014;26(10):1176-80.
23. Keshteli AH, Dehestani B, Daghaghzadeh H, Adibi P. Epidemiological features of irritable bowel syndrome and its subtypes among Iranian adults. Ann Gastroenterol. 2015;28(2):253.
24. Yao X, Yang YS, Cui LH, et al. Subtypes of irritable bowel syndrome on Rome III criteria: a multicenter study. J Gastroenterol Hepatol. 2012;27(4):760-5.
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IssueVol 6 No 4 (2020) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/jbe.v6i4.5685
Keywords
Epidemiology Clinical Characteristics Celiac disease Irritable bowel syndrome.
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How to Cite
1.
Neishaboori H, Abdollahi Sabet S, Moharrami Yeganeh P, Azimi Pirsaraei SV. The Epidemiological and Clinical Characteristics of Celiac Disease among Patients with Irritable Bowel Syndrome in Zanjan Province, Iran. JBE. 2021;6(4):282-289.