Irritable Bowel Syndrome and Gluten-Related Disorders

Nutrients. 2020 Apr 17;12(4):1117. doi: 10.3390/nu12041117.


Background: Irritable bowel syndrome (IBS) is frequently associated with celiac disease (CD) and nonceliac gluten/wheat sensitivity (NCGS/NCWS), but epidemiological and pathophysiological aspects are still unclear. Furthermore, a gluten-free diet (GFD) can positively influence IBS symptoms. Methods: A comprehensive online search for IBS related to CD, NCGS and GFD was made using the Pubmed, Medline and Cochrane databases. Results: Although a systematic screening for CD in IBS is not recommended, CD prevalence can be increased in diarrhea-predominant IBS patients. On the other hand, IBS symptoms can be persistent in treated CD patients, and their prevalence tends to decrease on a GFD. IBS symptoms may overlap and be similar to those associated to nonceliac gluten and/or wheat sensitivity. Increased gut permeability could explain the gluten/wheat effects in IBS patients. Finally, a GFD could improve symptoms in a subgroup of IBS patients. Conclusions: The possible interplay between IBS and gluten-related disorders represents a scientifically and clinically challenging issue. Further studies are needed to confirm these data and better clarify the involved pathophysiological mechanisms.

Keywords: celiac disease; gluten-free diet; irritable bowel syndrome; nonceliac gluten/wheat sensitivity.

Publication types

  • Systematic Review

MeSH terms

  • Celiac Disease* / epidemiology
  • Celiac Disease* / etiology
  • Comorbidity
  • Diarrhea
  • Diet, Gluten-Free*
  • Female
  • Gastrointestinal Tract / metabolism
  • Glutens / adverse effects
  • Humans
  • Irritable Bowel Syndrome* / epidemiology
  • Irritable Bowel Syndrome* / etiology
  • Male
  • Permeability
  • Prevalence
  • Triticum / adverse effects


  • Glutens