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Testing for Celiac Disease in Patients With Symptoms of Irritable Bowel Syndrome

Weekitt Kittisupamongkol, MD
JAMA. 2009;301(11):1126. doi:10.1001/jama.2009.272.
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To the Editor: In their Rational Clinical Examination article, Dr Ford and colleagues1 considered history and physical examination in establishing irritable bowel syndrome (IBS) as a cause of a patient's lower gastrointestinal symptoms. In their discussion, they stated that current guidelines for the management of IBS do not recommend routine screening for celiac disease.

I disagree with this approach. Tests for celiac disease should be made in any patients who fulfill Rome criteria with diarrhea-predominant IBS.2 Such a syndrome is associated with poorly responsive celiac disease and one of the indications for serological screening of celiac disease.3 Even in a population with low prevalence of celiac disease, it can be cost-effective to screen for this disorder in patients with suspected IBS.4

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References

March 18, 2009
Alexander C. Ford, MD, MRCP; Nicholas J. Talley, MD, PhD; Paul Moayyedi, PhD, FRCP
JAMA. 2009;301(11):1126. doi:10.1001/jama.2009.273.
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