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Gynecological Disorders in Patients with Non-celiac Wheat Sensitivity

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Abstract

Background

Non-celiac wheat sensitivity (NCWS) most frequently presents clinically with irritable bowel syndrome (IBS)-like symptoms, although many extra-intestinal manifestations have also been attributed to it. No studies to date have evaluated the presence and frequency of gynecological symptoms in NCWS.

Aim

To evaluate the frequency of gynecological disorders in patients with NCWS.

Patients and Methods

Sixty-eight women with NCWS were included in the study. A questionnaire investigating gynecological symptoms and recurrent cystitis was administered, and patients reporting symptoms were then examined by specialists. Three control groups were selected: 52 patients with IBS not related to NCWS, 56 patients with celiac disease (CD), and 71 healthy controls.

Results

59% of the patients with NCWS showed gynecological symptoms, a higher frequency than in healthy controls (P = 0.04), IBS controls (P = 0.01) and CD controls (P = 0.02). Menstrual cycle alterations were more frequent in patients with NCWS than in healthy controls (26.5% vs 11.3%; P = 0.03); the patients with NCWS suffered from recurrent vaginitis (16%) and dyspareunia (6%) significantly more frequently than healthy controls. Twenty-nine percent of patients with NCWS reported recurrent cystitis, a finding higher than in the control groups (vs healthy P = 0.0001, vs IBS P = 0.001, vs CD controls P = 0.04). Microbiological examinations were negative in most of the patients with NCWS and recurrent vaginitis or cystitis. During the 1-year follow-up, 46% of patients with menstrual disorders and 36% with recurrent vaginitis reported resolution of symptoms on a wheat-free diet.

Conclusions

Patients with NCWS showed a significantly higher frequency of gynecological symptoms and recurrent cystitis than patients with IBS.

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Abbreviations

NCWS:

Non-celiac wheat sensitivity

CD:

Celiac disease

IBS:

Irritable bowel syndrome

DBPC:

Double-blind placebo controlled

IEL:

Intra-epithelial lymphocyte(s)

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Acknowledgments

We wish to thank English native speaker Carole Greenall for revising the text.

Funding

The study was funded by the Italian Health Ministry, Grant PE-2016-02363692 “Non-celiac gluten sensitivity (NCGS): is gluten the true culprit? A clinical and immunological study on the tolerability of different wheat grains in NCGS patients.”

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Authors and Affiliations

  1. Internal Medicine Unit, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90129, Palermo, Italy

    Maurizio Soresi, Pasquale Mansueto, Giuseppe Incandela, Francesco La Blasca, Francesca Fayer, Alberto D’Alcamo & Antonio Carroccio

  2. Gynecology Unit, Giovanni Paolo II Hospital, Sciacca, Italy

    Salvatore Incandela

  3. Pathology Unit, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90129, Palermo, Italy

    Ada Maria Florena

Authors
  1. Maurizio Soresi
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  2. Salvatore Incandela
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  3. Pasquale Mansueto
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  4. Giuseppe Incandela
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  5. Francesco La Blasca
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  6. Francesca Fayer
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  7. Alberto D’Alcamo
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  8. Ada Maria Florena
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  9. Antonio Carroccio
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Contributions

AC, SI, and MS had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. AC contributed to study concept and design. AC, SI, PM, FLB, AD, and GI collected the data. FF contributed to serum marking. Histology study was done by AMF. Microbiological study was done by GF. MS carried out the statistical analysis.AC, SI, and PM carried out the analysis and interpretation of data. Drafting of the manuscript was done by AC and MS. Critical revision of the manuscript for important intellectual content was performed by AC, PM, and MS. All authors had access to the study data and reviewed and approved the final manuscript.

Corresponding author

Correspondence to Antonio Carroccio.

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Conflict of interest

None of the authors have conflict of interest to declare.

Ethical approval

The study protocol conformed to the ethical guidelines of the Declaration of Helsinki. It was approved by the Human Research Committee of the University of Palermo and registered at clinicaltrials.gov (Registration Number: NCT03027492, “Gynecological Disorders in Not-celiac Wheat Sensitivity”).

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Soresi, M., Incandela, S., Mansueto, P. et al. Gynecological Disorders in Patients with Non-celiac Wheat Sensitivity. Dig Dis Sci 66, 167–174 (2021). https://doi.org/10.1007/s10620-020-06184-8

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  • DOI: https://doi.org/10.1007/s10620-020-06184-8

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