Celiac disease and non-celiac gluten sensitivity – characteristics and differences

Introduction Celiac disease is a quite common condition resulting from the interaction of genetic, immunological, and environmental factors, with the main environmental factor being exposure to gluten. Non-celiac gluten sensitivity (NCGS) affects individuals without celiac disease or wheat allergy and is characterized by intestinal and extraintestinal symptoms related to the consumption of grain products, without accompanying damage to the intestinal mucosa. Discussion Gluten is a grain protein that is resistant to digestive enzymes and accumulates in the intestines, leading to tissue damage and the release of tissue transglutaminase 2 (tTG2) enzyme, which increases gluten immunogenicity. The presence of HLA-DQ2 or HLA-DQ8 gene variants in the genome is a necessary condition for the development of the disease, but it does not always lead to celiac disease. The pathomechanism of non-celiac gluten sensitivity is not yet fully understood. Diagnosis of celiac disease involves serological tests, genetic tests, and histological examination. Conclusions The only effective treatment for celiac disease is a strict gluten-free diet, which involves eliminating wheat, rye, barley, and triticale from one's diet. Further research is necessary to search for effective therapies. The approach for NCGS involves introducing an appropriate diet - either low FODMAP or gluten-free

Irritable bowel syndrome – modern ways of treatment

Introduction Irritable bowel syndrome (IBS) is the most frequent functional disorder of the gastrointestinal tract.  Main symptoms are recurring stomach ache connected with defecation, changes of frequency of defecation and/or stool’s consistency. Cause of IBS is still unknown unlike its pathomechanism. Continuous research allows doctors to understand and treat it better. Discussion Diagnosing IBS might be difficult even for the most experienced doctors due to its uncharacteristic symptoms. Therefore diagnosis should be made by using Rome IV Criteria. IBS is divided into 4 subtypes  basing on clinical picture: IBS with predominant constipation, IBS with predominant diarrhea, IBS with mixed bowel habits and IBS unclassified. Classification is being performed with the use of Bristol Stool Chart. Choice of remedy should be made depending on the subtype of IBS. Pharmacological treatment is symptomatic and focuses on relieving pain, diarrhea, constipation and bloating. Drugs that can be used are: loperamide, rifaximin, antispasmodic (e.g. hyoscine), antidepressants or laxatives. Treatment should also contain nonpharmacological methods. Nonpharmacological techniques which are proved to help patients contain regular physical activity, body mass reduction, low-FODMAP diet, using probiotics, psychotherapy and supplementing soluble fibre. Conclusions IBS is a big issue for public health as it is lowering quality of life and is generating big indirect costs. Difficulties in diagnosing are increasing those costs. That’s why it is of high importance to find more effective therapy. Raising awareness among doctors is crucial as plenty of methods are available to treat the disease which allows to reduce symptoms and costs