Digestive Diseases and Sciences

, Volume 59, Issue 6, pp 1255–1261

Characteristics of Patients Who Avoid Wheat and/or Gluten in the Absence of Celiac Disease

  • Anna Tavakkoli
  • Suzanne K. Lewis
  • Christina A. Tennyson
  • Benjamin Lebwohl
  • Peter H. R. Green
Original Article

DOI: 10.1007/s10620-013-2981-6

Cite this article as:
Tavakkoli, A., Lewis, S.K., Tennyson, C.A. et al. Dig Dis Sci (2014) 59: 1255. doi:10.1007/s10620-013-2981-6

Abstract

Background

Gastrointestinal symptoms that respond to the removal of wheat and/or gluten are becoming more common. Patients who avoid wheat and/or gluten (PWAWG) are a heterogeneous group and predominantly self-diagnosed prior to presenting for clinical evaluation.

Specific aim

We characterized PWAWGs seen at a tertiary care referral center and compared them to patients with celiac disease (CD) and subjects in the National Health and Nutrition examination survey (NHANES).

Methods

This was a cross-sectional study evaluating patients seen by four gastroenterologists at a CD referral center. Baseline characteristics, laboratory values, and medical comorbidities were compared to CD patients who presented at the same center and subjects enrolled in NHANES.

Results

Eighty-four PWAWGs were identified and compared to 585 CD patients and 2,686 NHANES patients. Thirty-two alternative diagnoses were made in 25 (30 %) PWAWGs, including small intestinal bacterial overgrowth and fructose/lactose intolerance. When compared to patients with CD, PWAWGs had similar body mass index (BMI, 23.1 vs. 23.5, p = 0.54) and mean hemoglobin value (13.4 vs. 13.3, p = 0.6). When compared to male and female patients in NHANES, BMI, folate, and mean hemoglobin values were lower in PWAWGs. Both male and female PWAWGs had a lower prevalence of hypertension.

Conclusion

While there are similarities between CD and PWAWGs that could possibly be due to shared HLA haplotypes or an effect of the gluten-free diet, alternative diagnoses are common in these patients. PWAWGs have a similar cardiovascular profile as CD patients in terms of lower BMI and lower prevalence of hypertension.

Keywords

Patients who avoid wheat and/or glutenCeliac diseaseGluten-free dietAlternative diagnoses

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Anna Tavakkoli
    • 1
  • Suzanne K. Lewis
    • 1
  • Christina A. Tennyson
    • 1
  • Benjamin Lebwohl
    • 1
    • 2
  • Peter H. R. Green
    • 1
  1. 1.Department of Medicine, Celiac Disease CenterColumbia UniversityNew YorkUSA
  2. 2.Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkUSA