A conundrum: wheat and gluten avoidance and its implication with endometriosis patients
Author: D. Shepperson Mills
The Endometriosis and Fertility Clinic, London, United Kingdom.
Objective
To determine if a relationship between endometriosis symptomatology and the ingestion of wheat and/or gluten exists. The objective is to show that for women the link is relevant, and that removing wheat and/or gluten from the diet may have beneficial effects.
Design
This is a retrospective analysis of data from a cohort of 363 laparoscopically diagnosed endometriosis patients using chi-squared tests.
Materials and methods
Each patient recorded at least 3 Clinical Audits, Measure Yourself Medical Outcome Profiles (MYMOP) from the Medical Research Council UK. Individual nutrition programs were advised, according to functional medicine findings. Patients were split into: Group A avoided wheat after consultation for a period of 1 to 3 months (n = 204); Group B avoided wheat prior to consultation (n = 114); Group C never avoided wheat (n = 45). MYMOP scores act as an indication of the benefit of the program and describe what symptoms reoccur on reintroduction of wheat and/or gluten.
Results
Patients who avoided wheat displayed a greater improvement in wellbeing than those who did not avoid wheat. The initial mean scores were for Group A 4.19, Group B 4.02, and Group C 4.02. Final mean scores were for Group A 2.67, Group B 2.48 and Group C 2.97. There was no significant difference between the original MYMOP groups' scores at the outset. At the end the difference between the initial score and third score for each group was calculated, showing a significant difference of 95% confidence levels between the groups. MYMOP analysis for Groups A and B show symptom categories after wheat was consumed again: bloating 243; diarrhoea/constipation 49; fatigue 89; headaches 12; resumption of pain 209.
Conclusion
Patients who avoid wheat had greater improvement in wellbeing and pain scores than those who ate wheat. It is hypothesized that the ingestion of wheat and/or gluten may have detrimental impacts on the endometriosis patients health. This requires further investigation. It may be advisable to test for gluten sensitivity.