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Some patients with diarrhea-predominant irritable bowel syndrome (IBS-D) but no evidence of celiac disease respond positively to gluten-free diets (JW Gen Med Jan 10 2013 and JW Gen Med Apr 5 2011). In a new trial, Mayo Clinic researchers randomized 45 patients with IBS-D to 4 weeks of gluten-containing or gluten-free diets; all patients had negative antibody tests for celiac disease.
The gluten-containing–diet group, compared with the gluten-free–diet group, exhibited the following significant abnormalities:
Greater mean daily stool frequency
Increased small bowel permeability (as determined by tests involving mannitol ingestion and excretion)
Abnormal expression of cellular tight-junction proteins (as determined by testing of intestinal biops…