Extra-intestinal manifestations of non-celiac gluten sensitivity: An expanding paradigm

Table 2 Main studies exploring the effect of gluten free diet in irritable bowel syndrome

Ref.	Country	Population	Outcome
Wahnschaffe et al[67], 2001	Germany	102 IBS-D	Stool frequency/bowel movement improved in DQ2-8 positive subjects
Aziz et al[68], 2016	United Kingdom	40 IBS-D	A 6-wk GFD reduced symptoms in 70%
Vazquez-Roque et al[69], 2013	United States	45 IBS-D	Stool frequency/bowel movement reduced in patients under GFD
Di Sabatino et al[5], 2015	Italy	59 IBS with self-diagnosis of NCGS	A challenge with 4 g/d of gluten worsened symptoms compared to placebo
Shahbazkhani et al[70], 2015	Iran	72 IBS	Worsening of intestinal symptoms with gluten compared to placebo
Zanwar et al[71], 2016	India	60 IBS	A 4-wk GFD improved a visual-analogue scale of symptoms
Elli et al[72], 2016	Italy	140 IBS with self-diagnosis of NCGS	Only the 14% showed a response to GFD as well as challenge test
Barmeyer et al[73], 2017	Germany	34 IBS	The 34% showed clinical improvement to GFD and continued for one year

GFD: Gluten free diet; IBS-D: Irritable bowel syndrome, diarrhea subtype; NCGS: Non celiac gluten sensitivity.