Efficacy of the gluten free diet in the management of functional gastrointestinal disorders: a systematic review on behalf of the Italian Society of Paediatrics
Abstract Background Functional gastrointestinal disorders (FGIDs) are characterized by chronic/recurrent gastrointestinal symptoms not related to organic disorders. Due to the limited treatment options and to the perception of subjects with FGIDs suffering from a food intolerance, in recent years th...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-01-01
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| Series: | Italian Journal of Pediatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13052-019-0606-1 |
| _version_ | 1818067340096438272 |
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| author | Elena Scarpato Renata Auricchio Francesca Penagini Angelo Campanozzi Gian Vincenzo Zuccotti Riccardo Troncone |
| author_facet | Elena Scarpato Renata Auricchio Francesca Penagini Angelo Campanozzi Gian Vincenzo Zuccotti Riccardo Troncone |
| author_sort | Elena Scarpato |
| collection | DOAJ |
| description | Abstract Background Functional gastrointestinal disorders (FGIDs) are characterized by chronic/recurrent gastrointestinal symptoms not related to organic disorders. Due to the limited treatment options and to the perception of subjects with FGIDs suffering from a food intolerance, in recent years there has been an increase in the self-prescription of elimination diets, especially gluten free diet (GFD), for the treatment of these disorders. For this reason, we decided to perform this systematic review with the aim to evaluate the available evidence on the effects of a GFD on gastrointestinal symptoms, in subjects with FGIDs. Methods Cochrane Library and MEDLINE (via PubMed) databases were searched, from inception to March 2018, using the MeSH terms “functional gastrointestinal disorder OR irritable bowel syndrome AND gluten”. We included all the clinical trials published in English and evaluating the effects of a GFD in subjects with FGIDs diagnosed according to the Rome II, III, and IV criteria. Results Eleven trials were eligible (3 prospective trials, 8 single or double-blind placebo-controlled trials), with 10/11 trials including adult subjects with irritable bowel syndrome (IBS) or FGIDs. Most of the prospective studies found an effect of GFD on gastrointestinal symptoms control. Nevertheless, 1 trial failed to find an association between gluten and GI symptoms when FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) content was simultaneously reduced in the diet, and 2 trials reported a worsening of symptoms during placebo administration. The results of the different trials are difficult to compare due to discrepancies in the study protocols regarding the amount and type of gluten administered, the duration of the gluten challenge, the type of placebo used, and the duration of the challenge itself. Conclusions According to our results, gluten may contribute to the occurrence of gastrointestinal symptoms in patients with FGIDs, particularly in those with IBS. Nevertheless, the results of the currently available trials are difficult to compare due to the lack of standardization in the study designs. For this reason, it is still not possible to recommend the use of the GFD in the routine management of FGIDs. |
| first_indexed | 2024-12-10T15:22:07Z |
| format | Article |
| id | doaj.art-202eea7d0c324b5b9faa76c14dad8e21 |
| institution | Directory Open Access Journal |
| issn | 1824-7288 |
| language | English |
| last_indexed | 2024-12-10T15:22:07Z |
| publishDate | 2019-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Italian Journal of Pediatrics |
| spelling | doaj.art-202eea7d0c324b5b9faa76c14dad8e212022-12-22T01:43:39ZengBMCItalian Journal of Pediatrics1824-72882019-01-0145111110.1186/s13052-019-0606-1Efficacy of the gluten free diet in the management of functional gastrointestinal disorders: a systematic review on behalf of the Italian Society of PaediatricsElena Scarpato0Renata Auricchio1Francesca Penagini2Angelo Campanozzi3Gian Vincenzo Zuccotti4Riccardo Troncone5Department of Translational Medical Sciences – Section of Paediatrics, University of Naples Federico IIDepartment of Translational Medical Sciences – Section of Paediatrics, University of Naples Federico IIDepartment of Pediatrics, University of Milan, V. Buzzi Children’s HospitalPediatrics, Department of Medical and Surgical Sciences, University of FoggiaDepartment of Pediatrics, University of Milan, V. Buzzi Children’s HospitalDepartment of Translational Medical Sciences – Section of Paediatrics, University of Naples Federico IIAbstract Background Functional gastrointestinal disorders (FGIDs) are characterized by chronic/recurrent gastrointestinal symptoms not related to organic disorders. Due to the limited treatment options and to the perception of subjects with FGIDs suffering from a food intolerance, in recent years there has been an increase in the self-prescription of elimination diets, especially gluten free diet (GFD), for the treatment of these disorders. For this reason, we decided to perform this systematic review with the aim to evaluate the available evidence on the effects of a GFD on gastrointestinal symptoms, in subjects with FGIDs. Methods Cochrane Library and MEDLINE (via PubMed) databases were searched, from inception to March 2018, using the MeSH terms “functional gastrointestinal disorder OR irritable bowel syndrome AND gluten”. We included all the clinical trials published in English and evaluating the effects of a GFD in subjects with FGIDs diagnosed according to the Rome II, III, and IV criteria. Results Eleven trials were eligible (3 prospective trials, 8 single or double-blind placebo-controlled trials), with 10/11 trials including adult subjects with irritable bowel syndrome (IBS) or FGIDs. Most of the prospective studies found an effect of GFD on gastrointestinal symptoms control. Nevertheless, 1 trial failed to find an association between gluten and GI symptoms when FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) content was simultaneously reduced in the diet, and 2 trials reported a worsening of symptoms during placebo administration. The results of the different trials are difficult to compare due to discrepancies in the study protocols regarding the amount and type of gluten administered, the duration of the gluten challenge, the type of placebo used, and the duration of the challenge itself. Conclusions According to our results, gluten may contribute to the occurrence of gastrointestinal symptoms in patients with FGIDs, particularly in those with IBS. Nevertheless, the results of the currently available trials are difficult to compare due to the lack of standardization in the study designs. For this reason, it is still not possible to recommend the use of the GFD in the routine management of FGIDs.http://link.springer.com/article/10.1186/s13052-019-0606-1Irritable bowel syndromeElimination dietAbdominal painGastrointestinal symptoms |
| spellingShingle | Elena Scarpato Renata Auricchio Francesca Penagini Angelo Campanozzi Gian Vincenzo Zuccotti Riccardo Troncone Efficacy of the gluten free diet in the management of functional gastrointestinal disorders: a systematic review on behalf of the Italian Society of Paediatrics Italian Journal of Pediatrics Irritable bowel syndrome Elimination diet Abdominal pain Gastrointestinal symptoms |
| title | Efficacy of the gluten free diet in the management of functional gastrointestinal disorders: a systematic review on behalf of the Italian Society of Paediatrics |
| title_full | Efficacy of the gluten free diet in the management of functional gastrointestinal disorders: a systematic review on behalf of the Italian Society of Paediatrics |
| title_fullStr | Efficacy of the gluten free diet in the management of functional gastrointestinal disorders: a systematic review on behalf of the Italian Society of Paediatrics |
| title_full_unstemmed | Efficacy of the gluten free diet in the management of functional gastrointestinal disorders: a systematic review on behalf of the Italian Society of Paediatrics |
| title_short | Efficacy of the gluten free diet in the management of functional gastrointestinal disorders: a systematic review on behalf of the Italian Society of Paediatrics |
| title_sort | efficacy of the gluten free diet in the management of functional gastrointestinal disorders a systematic review on behalf of the italian society of paediatrics |
| topic | Irritable bowel syndrome Elimination diet Abdominal pain Gastrointestinal symptoms |
| url | http://link.springer.com/article/10.1186/s13052-019-0606-1 |
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