This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related article  • Related letter  • Similar articles in JAMA  Topic Collections  • Nutritional and Metabolic Disorders  • Malabsorption Syndromes  • Quality of Care  • Quality of Care, Other  • Diagnosis  • Gastroenterology  • Gastrointestinal Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In Reply: Our systematic review focused on the role of the history and physical examination in making a diagnosis of IBS. It was not intended to be a guideline on how to manage IBS, so the issue of testing for celiac disease was not addressed in detail. We agree, however, that testing for celiac disease, with tissue transglutaminase (tTG) or anti-endomysial antibodies (EMAs), followed by distal duodenal biopsy for those testing positive, is useful in individuals presenting with symptoms suggestive of IBS. In another systematic review and meta-analysis that examined the yield of testing for celiac disease in patients meeting diagnostic criteria for IBS, the pooled prevalence of positive tTG or EMA in 13 studies containing 2021 individuals with symptoms suggestive of IBS was 1.6%, and the pooled prevalence of biopsy-proven celiac disease in 7 studies containing 1464 patients meeting diagnostic criteria for IBS was 4.1%.¹ The odds ratio for . . . [Full Text of this Article]

Alexander C. Ford, MD, MRCP
Gastroenterology Division
McMaster University Health Sciences Center
Hamilton, Ontario, Canada

Nicholas J. Talley, MD, PhD
Department of Medicine
Mayo Clinic Florida
Jacksonville

Paul Moayyedi, PhD, FRCP
Gastroenterology Division
McMaster University Health Sciences Center
Hamilton

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Will the History and Physical Examination Help Establish That Irritable Bowel Syndrome Is Causing This Patient's Lower Gastrointestinal Tract Symptoms?
Alexander C. Ford, Nicholas J. Talley, Sander J. O. Veldhuyzen van Zanten, Nimish B. Vakil, David L. Simel, and Paul Moayyedi
JAMA. 2008;300(15):1793-1805.
ABSTRACT | FULL TEXT  

RELATED LETTER

Testing for Celiac Disease in Patients With Symptoms of Irritable Bowel Syndrome
Weekitt Kittisupamongkol
JAMA. 2009;301(11):1126.
EXTRACT | FULL TEXT