ABSTRACT
BACKGROUND: Non-celiac wheat sensitivity (NCWS) most frequently presents clinically with irritable bowel syndrome (IBS)-like symptoms, although many extra-intestinal manifestations have also been attributed to it. No studies to date have evaluated the presence and frequency of gynecological symptoms in NCWS. AIM: To evaluate the frequency of gynecological disorders in patients with NCWS. PATIENTS AND METHODS: Sixty-eight women with NCWS were included in the study. A questionnaire investigating gynecological symptoms and recurrent cystitis was administered, and patients reporting symptoms were then examined by specialists. Three control groups were selected: 52 patients with IBS not related to NCWS, 56 patients with celiac disease (CD), and 71 healthy controls. RESULTS: 59% of the patients with NCWS showed gynecological symptoms, a higher frequency than in healthy controls (P = 0.04), IBS controls (P = 0.01) and CD controls (P = 0.02). Menstrual cycle alterations were more frequent in patients with NCWS than in healthy controls (26.5% vs 11.3%; P = 0.03); the patients with NCWS suffered from recurrent vaginitis (16%) and dyspareunia (6%) significantly more frequently than healthy controls. Twenty-nine percent of patients with NCWS reported recurrent cystitis, a finding higher than in the control groups (vs healthy P = 0.0001, vs IBS P = 0.001, vs CD controls P = 0.04). Microbiological examinations were negative in most of the patients with NCWS and recurrent vaginitis or cystitis. During the 1-year follow-up, 46% of patients with menstrual disorders and 36% with recurrent vaginitis reported resolution of symptoms on a wheat-free diet. CONCLUSIONS: Patients with NCWS showed a significantly higher frequency of gynecological symptoms and recurrent cystitis than patients with IBS.
Subject(s)
Celiac Disease , Cystitis/epidemiology , Irritable Bowel Syndrome/epidemiology , Vaginitis/epidemiology , Wheat Hypersensitivity/epidemiology , Adult , Cystitis/diagnosis , Cystitis/diet therapy , Diet, Gluten-Free/methods , Female , Follow-Up Studies , Humans , Irritable Bowel Syndrome/diagnosis , Irritable Bowel Syndrome/diet therapy , Middle Aged , Prospective Studies , Vaginitis/diagnosis , Vaginitis/diet therapy , Wheat Hypersensitivity/diagnosis , Wheat Hypersensitivity/diet therapy , Young AdultABSTRACT
La microbiota de cada individuo se estima en 2,5-3 kg de peso. La colonización bacteriana comienza en el momento del parto, por contacto del feto con la microbiota vaginal e intestinal de la madre. Los oligosacáridos de la leche materna estimulan el crecimiento de bacterias, que proporcionan el ambiente adecuado para el desarrollo de la inmunidad de la mucosa intestinal. Además, la leche materna es portadora de su propia microbiota, la cual se altera en las mastitis. La vagina constituye otro importante microambiente. Las disbiosis en esta zona conducen a la aparición de vaginosis bacteriana y candidiasis, siendo ambas una patología muy frecuente en la mujer en edad fértil. Los probióticos se presentan como tratamiento potencial y alentador de toda la patología asociada a alteraciones de la microbiota. Son necesarios más estudios que confirmen el beneficio de los probióticos en este campo (AU)
The human microbiota is estimated to be 2.5-3.0 kg. Bacterial colonization starts during delivery, due to fetal contact with vaginal and intestinal maternal microorganisms. The oligosaccharides in human breast milk stimulate the growth of bacteria, which provide the optimal environment for intestinal mucosal immunity development. Additionally, breast milk has its own microbiota and it is altered in mastitis. The vagina is another important microenvironment. Vaginal dysbiosis leads to bacterial vaginosis and vaginal candidiasis, both of them very frequent in reproductive life. The probiotics are a potential and encouraging treatment for all microbiota alterations. Nevertheless, additional studies are required to confirm the benefits of probiotics (AU)
