{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T01:28:39Z","timestamp":1774402119501,"version":"3.50.1"},"reference-count":26,"publisher":"PAGEPress Publications","issue":"3","license":[{"start":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T00:00:00Z","timestamp":1694995200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reumatismo"],"abstract":"<jats:p>Objective. Dietary interventions to improve fibromyalgia (FM) symptoms reported conflicting results. This study aimed to treat FM patients with a gluten-free diet (GFD), alternated with a non-restricted gluten-containing diet, followed by a rechallenge of the GFD.\nMethods. Twenty postmenopausal women with FM and no history of celiac disease participated. A GFD was assigned for 6 months. This was followed by 3 months of a non-restricted gluten-containing diet and then a new GFD for another 6 months. At each visit, the widespread pain index (WPI) and the symptom severity scale (SS) scores were evaluated.\nResults. The mean age of the patients enrolled was 53.9\u00b110 years. None of the patients had a diagnosis of irritable bowel disease, although they reported vague gastrointestinal symptoms. After 6 months of a GFD, a statistically significant reduction was observed for the WPI (10.3\u00b11.8 vs 7.7\u00b11.4; p&lt;0.0001) and the SS scale (6.4\u00b11.8 vs 4.15\u00b11.6; p=0.0002). The D percentage reduction of the WPI after 6 months of GFD was -24%\u00b19%, while for the SS scale, it was -36%\u00b121%. The following reintroduction of a gluten-containing diet brought about a statistically significant rise in the absolute SS scale and WPI, as well as a D modification of the WPI (21%\u00b113%) and of the SS scale (74%\u00b190%). The rechallenge of the GFD showed a significant improvement in absolute and D WPI (-24%\u00b17%) and SS (-36%\u00b111%). No modifications to the body mass index were found.\nConclusions. A GFD improved FM symptoms evaluated with WPI and SS. This was confirmed for the first time, also with a rechallenge of the GFD that followed a non-restricted gluten-containing diet.<\/jats:p>","DOI":"10.4081\/reumatismo.2023.1530","type":"journal-article","created":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T09:49:50Z","timestamp":1695030590000},"source":"Crossref","is-referenced-by-count":5,"title":["Efficacy of a gluten-free diet in reducing the widespread pain index and symptom severity scale in patients affected by fibromyalgia"],"prefix":"10.4081","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7342-6350","authenticated-orcid":false,"given":"V.","family":"Bruzzese","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Marrese","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2055-7282","authenticated-orcid":false,"given":"P.","family":"Scolieri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Pepe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2549","published-online":{"date-parts":[[2023,9,18]]},"reference":[{"key":"4991","doi-asserted-by":"crossref","unstructured":"Wolfe F, Clauw D, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American college of rheumatology preliminary diagnostic criteria for \ufb01bromyalgia and measurement of symptom severity. Arthritis Care Res 2010; 62: 600-10.","DOI":"10.1002\/acr.20140"},{"key":"4992","doi-asserted-by":"crossref","unstructured":"Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, H\u00e4user W, Katz RS, et al. Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modi\ufb01cation of the ACR preliminary diagnostic criteria for \ufb01bromyalgia. J Rheumatol 2011; 38: 1113-22.","DOI":"10.3899\/jrheum.100594"},{"key":"4993","doi-asserted-by":"crossref","unstructured":"Verdu EF, Armstrong D, Murray JA. Between celiac disease and irritable bowel syndrome: the \u201cno man\u2019s land\u201d of gluten sensitivity. Am J Gastroentrol 2009; 104: 1587-94.","DOI":"10.1038\/ajg.2009.188"},{"key":"4994","doi-asserted-by":"crossref","unstructured":"Al-Toma A, Volta U, Auricchio R, Castillejo G, Sanders DS, Cellier C, et al. European society for the study of coeliac disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterol J 2019; 7: 583-613.","DOI":"10.1177\/2050640619844125"},{"key":"4995","doi-asserted-by":"crossref","unstructured":"Volta U, Bardella MT, Calabr\u00f2 A, Troncone R, Corazza GR, Study Group for Non-Celiac Gluten Sensitivity. An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Med 2014; 2: 85.","DOI":"10.1186\/1741-7015-12-85"},{"key":"4996","doi-asserted-by":"crossref","unstructured":"Aziz I, Hadjivassiliou M, Sanders DS. The spectrum of noncoeliac gluten sensitivity. Nat Rev Gastroenterol Hepatol 2015; 12: 516-26.","DOI":"10.1038\/nrgastro.2015.107"},{"key":"4997","doi-asserted-by":"crossref","unstructured":"Lubrano E, Ciacci C, Ames PR, Mazzacca G, Oriente P, Scarpa R. The arthritis of celiac disease: prevalence and pattern in 200 adult patients. Br J Rheumatol 1996; 35: 1314-8.","DOI":"10.1093\/rheumatology\/35.12.1314"},{"key":"4998","doi-asserted-by":"crossref","unstructured":"Nisihara R, Marques AP, Mei A, Skare T. Celiac disease and fibromyalgia: is there an association? Rev Esp Enferm Dig 2016; 108: 107-8.","DOI":"10.17235\/reed.2015.3992\/2015"},{"key":"4999","doi-asserted-by":"crossref","unstructured":"Jeffery IB, O\u2019Toole PW, \u00d6hman L, Claesson MJ, Deane J, Quigley EMM, et al. An irritable bowel syndrome by species-specific alteration in faecal microbiota. Gut 2012; 61: 997-1006.","DOI":"10.1136\/gutjnl-2011-301501"},{"key":"5000","doi-asserted-by":"crossref","unstructured":"Shivaji S. We are not alone: a case for the human microbiome in extra intestinal diseases. Gut Pathog 2017; 9: 13.","DOI":"10.1186\/s13099-017-0163-3"},{"key":"5001","doi-asserted-by":"crossref","unstructured":"Jethwa H, Abraham S. The evidence for microbiome manipulation in inflammatory arthritis. Rheumatology 2017; 56: 1452-60.","DOI":"10.1093\/rheumatology\/kew374"},{"key":"5002","doi-asserted-by":"crossref","unstructured":"Macfarlane GJ, Kronisch C, Dean LE, Atzeni F, H\u00e4user W, Flu\u00df E, et al. EULAR revised recommendation for the management of fibromyalgia. Ann Rheum Dis 2017; 76: 318-28.","DOI":"10.1136\/annrheumdis-2016-209724"},{"key":"5003","doi-asserted-by":"crossref","unstructured":"Silva AR, Bernardo A, Costa J, Cardoso A, Santos P, de Mesquita MF, et al. Dietary interventions in fibromyalgia: a systematic review. Ann Med 2019; 51: 2-14.","DOI":"10.1080\/07853890.2018.1564360"},{"key":"5004","doi-asserted-by":"crossref","unstructured":"Slim M , Calandre EP, Garcia-Leiva JM, Rico-Villademoros F, Molina-Barea R, Rodriguez-Lopez CM, et al. The effects of a gluten-free diet versus a hypocaloric diet among patients with fibromyalgia experiencing gluten sensitivity-like symptoms: a pilot, open-label randomized clinical trial. J Clin Gastroenterol 2017; 51: 500-7.","DOI":"10.1097\/MCG.0000000000000651"},{"key":"5005","unstructured":"Rossi A, Di Lollo AC, Guzzo MP, Giacomelli C, Atzeni F, Bazzichi L, et al. Fibromyalgia and nutrition: what news? Clin Exp Rheumatol 2015; 33: S117-25."},{"key":"5006","doi-asserted-by":"crossref","unstructured":"Isasi C, Tejerina E, Moran ML. Non-celiac gluten sensitivity and rheumatic diseases. Reumatol Clin 2016; 12: 4-10. [Article in Spanish]","DOI":"10.1016\/j.reumae.2015.11.004"},{"key":"5007","doi-asserted-by":"crossref","unstructured":"Taubman B, Mamula P, Sherry DD. Prevalence of asymptomatic celiac disease in children with fibromyalgia: a pilot study. Pediatric Rheumatology 2011; 9: 11.","DOI":"10.1186\/1546-0096-9-11"},{"key":"5008","doi-asserted-by":"crossref","unstructured":"Rodrigo L, Blanco I, Bobes J, de Serres FJ, et al. Effect of one year of a gluten-free diet on the clinical evolution of irritable bowel syndrome plus fibromyalgia in patients with associated lymphocytic enteritis: a case-control study. Arthritis Res Ther 2014; 16: 421.","DOI":"10.1186\/PREACCEPT-2049244887124904"},{"key":"5009","doi-asserted-by":"crossref","unstructured":"Volta U. Gluten-free diet in the management of patients with irritable bowel syndrome, fibromyalgia and lymphocytic enteritis. Arthritis Res Ther 2014; 16: 505.","DOI":"10.1186\/s13075-014-0505-1"},{"key":"5010","doi-asserted-by":"crossref","unstructured":"Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, H\u00e4user W, Katz RL, et al. 2016 revisions to the 2010\/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum 2016; 46: 319-29.","DOI":"10.1016\/j.semarthrit.2016.08.012"},{"key":"5011","doi-asserted-by":"crossref","unstructured":"Vanuytsel T, Vermeire S, Cleynen I. The role of haptoglobin and its related protein, zonulin, in inflammatory bowel disease. 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Rheumatol Int 2015; 35: 433-44.","DOI":"10.1007\/s00296-014-3109-9"},{"key":"5015","doi-asserted-by":"crossref","unstructured":"Rodrigo L, Blanco I, Bobes J, de Serres FJ. Clinical impact of a gluten-free diet on health-related quality of life in seven fibromyalgia syndrome patients with associated celiac disease. BMC Gastroenterol 2013; 13: 157.","DOI":"10.1186\/1471-230X-13-157"},{"key":"5016","doi-asserted-by":"crossref","unstructured":"Aman MM, Jason Yong R, Kaye AD, Urman RD. Evidence-based non-pharmacological therapies for fibromyalgia. Curr Pain Headache 2018; 22: 33.","DOI":"10.1007\/s11916-018-0688-2"}],"container-title":["Reumatismo"],"original-title":[],"link":[{"URL":"https:\/\/www.reumatismo.org\/index.php\/reuma\/article\/download\/1530\/986","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.reumatismo.org\/index.php\/reuma\/article\/download\/1530\/986","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T09:49:58Z","timestamp":1695030598000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.reumatismo.org\/index.php\/reuma\/article\/view\/1530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,18]]},"references-count":26,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,9,18]]}},"URL":"https:\/\/doi.org\/10.4081\/reumatismo.2023.1530","relation":{},"ISSN":["2240-2683","0048-7449"],"issn-type":[{"value":"2240-2683","type":"electronic"},{"value":"0048-7449","type":"print"}],"subject":[],"published":{"date-parts":[[2023,9,18]]}}}