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Celiac Disease in Adult South Indian Patients with Diarrhoea Dominant Irritable Bowel Syndrome
 
Avinash Bhat Balekuduru1, Vinusha Reddy2, Satyaprakash Bonthala Subbaraj1, Sanjay. V. Kulkarni
1Department of Gastroenterology, 2Department of General Medicine, Ramaiah Medical College, Bengaluru, Karnataka-54. India.


Corresponding Author
:
Dr Avinash Bhat Balekuduru
Email: avinashbalekuduru@gmail.com


Abstract

Aim & Objectives of the Study: There is paucity of data of prevalence of Celiac disease (CD) in South Indians. Our aim was to study the proportion of CD among patients presenting with diarrhoea dominant irritable bowel syndrome (IBS-D).
Material and Methods: From September 2013 to August 2015, 110 adult IBS –D and 100 age and sex matched controls with functional dyspepsia (FD) were recruited in the prospective cross sectional study done at Ramaiah hospitals, Bangalore. FD and IBS-D were diagnosed based on ROME III criteria. CD was diagnosed by modified ESPGAN criteria. Serum IgA anti tissue transglutaminase (Ig A anti- tTG) antibodies were measured and  esophagogastroduodenoscopy with duodenal biopsies  were performed in all the patients. The study was approved by the institutional ethical committee. 
Results: CD was diagnosed in 2 (1.8%) of 110 IBS-D and 1 (1 %) of 100 FD group. Mean age of the patients 39.4±2.6 (Range-18- 65 years). IgA anti-tTG antibodies were positive in 4 in IBS –D and 2 in control group. Duodenal biopsy showed features of CD in 3- modified marsh grading of III in 2 IBS-D and II in 1 control groups. All patients improved symptomatically on gluten free diet.
Conclusions: CD in the present study was noted in 1.8% in IBS-D and 1% in FD group. Larger screening programs involving different regions are needed for estimating true CD prevalence.