Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
John Cavenagh, MBA, PhD, PA-C
Objective: The objective of this selective EBM review is to determine whether or not a gluten-free diet is effective in decreasing symptoms for irritable bowel syndrome (IBS).
Study Design: Systemic review of three randomized, double-blind, placebo-controlled trials published between 2010-2016, all in the English language.
Data Sources: Data sources obtained for this review were studies published in peer reviewed journals found using PubMed Database and were selected based on outcomes measured and relevance to the objective.
Outcomes Measured: The outcomes measured were based on reduction in abdominal symptoms in IBS patients. Outcomes were measured by a series of 10 cm Visual Analog Scale (VAS). The VAS monitored symptoms with 0 representing no symptoms and 10 indicating severe clinical symptoms. Symptoms observed included abdominal pain, bloating, satisfaction with stool consistency, and overall well-being. Patients completed a questionnaire on primary outcomes and symptoms. Significance of outcomes were determined using p-value, relative benefit increase, absolute benefit increase, and numbers needed to treat.
Results: All three studies showed a significant decrease in abdominal symptoms in IBS patients following a gluten-free diet. Biesiekierski et al. found a statistically significant decrease in abdominal symptoms at the end of the 6 weeks study with patients who had the gluten-free diet compared to the gluten diet (p=0.001). Elli et al. study also found a significant difference in patients that had the gluten-free diet compared to the gluten diet (p= 0.001). Shahbazkhani et al. found reduction in abdominal symptoms with a gluten-free diet (p< 0.001).
Conclusions: The randomized controlled trials discussed in this review suggest that a gluten-free diet is effective in decreasing symptoms for IBS.
Larkin, Christina T., "Is Maintaining a Gluten-Free Diet Effective in Decreasing Symptoms for Irritable Bowel Syndrome?" (2018). PCOM Physician Assistant Studies Student Scholarship. 369.