The association between fibromyalgia and non-celiac gluten sensitivity has been observed for some time. This article discusses recent research confirming this relationship. More importantly, gluten elimination resulted in improvement in all patients is this small series. The authors are following a larger cohort with 90 of 246 patients showing significant response to gluten-free diet.
Patients with fibromyalgia should be screened for celiac disease before commencing a gluten-free diet.
Fibromyalgia and non-celiac gluten sensitivity: a description with remission of fibromyalgia
Carlos Isasi1, Isabel Colmenero, Fernando Casco, Eva Tejerina, Natalia Fernandez, José I. Serrano-Vela, Maria J. Castro and Luis F. Villa
Rheumatology International Clinical and Experimental Investigations 2014
Fibromyalgia (FM) syndrome is a disabling clinical condition of unknown cause, and only symptomatic treatment with limited benefit is available. Gluten sensitivity that does not fulfill the diagnostic criteria for celiac disease (CD) is increasingly recognized as a frequent and treatable condition with a wide spectrum of manifestations that overlap with the manifestations of FM, including chronic musculoskeletal pain, asthenia, and irritable bowel syndrome. The aim of this report was to describe 20 selected patients with FM without CD who improved when placed on a gluten-free diet. An anti-transglutaminase assay, duodenal biopsy, and HLA typing were performed in all cases. CD was ruled out by negative anti-transglutaminase assay results and absence of villous atrophy in the duodenal biopsy. All patients had intraepithelial lymphocytosis without villous atrophy. Clinical response was defined as achieving at least one of the following scenarios: remission of FM pain criteria, return to work, return to normal life, or the discontinuation of opioids. The mean follow-up period was 16 months (range 5–31). This observation supports the hypothesis that non-celiac gluten sensitivity may be an underlying cause of FM syndrome.
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