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Claire

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Claire Collaborator

I was hunting for one thing and found another. Thought this might be interesting to many here on the forum. Claire

HIGH PREVALENCE OF SMALL INTESTINAL BACTERIAL OVERGROWTH IN CELIAC PATIENTS WITH PERSISTENCE OF GASTROINTESTINAL SYMPTOMS AFTER GLUTEN WITHDRAWEL

Celiac disease is a gluten-sensitive enteropathy with a broad spectrum of clinical manifestation, and most celiac patients respond to a gluten-free diet. However, in some rare cases, celiacs continue to experience GI symptoms after being on a GFD, despite optimal adherence to diet. This study evaluates the causes of persistence of GI symptoms in a series of consecutive celiac patients fully compliant to GFD.

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Claire Collaborator

The above post contains a URL that has been changed and the new one is not turning up the article. I found it elsewhere and am posting it below: - Claire

High Prevalence of Small Intestinal Bacterial Overgrowth in Celiac Patients with Persistence of Gastrointestinal Symptoms after Gluten Withdrawal.

Tursi A, Brandimarte G, Giorgetti G.

Department of Emergency, "L. Bonomo" Hospital, Andria (BA), Italy.

OBJECTIVE: Celiac disease is a gluten-sensitive enteropathy with a broad spectrum of clinical manifestation, and most celiac patients respond to a gluten-free diet (GFD). However, in some rare cases celiacs continue to experience GI symptoms after GFD, despite optimal adherence to diet. The aim of our study was to evaluate the causes of persistence of GI symptoms in a series of consecutive celiac patients fully compliant to GFD. METHODS: We studied 15 celiac patients (five men, 10 women, mean age 36.5 yr, range 24-59 yr) who continued to experience GI symptoms after at least 6-8 months of GFD (even if of less severity). Antigliadin antibody (AGA) test, antiendomysial antibody (EMA) test, and sorbitol H2-breath test (H2-BT), as well as esophagogastroduodenoscopy (EGD) with histological evaluation, were performed before starting GFD. Bioptic samples were obtained from the second duodenal portion during EGD, and histopathology was expressed according to the Marsh classification. To investigate the causes of persistence of GI symptoms in these patients, we performed AGA and EMA tests, stool examination, EGD with histological examination of small bowel mucosa, and sorbitol-, lactose-, and lactulose H2-breath tests. RESULTS: Histology improved in all patients after 6-8 months of GFD; therefore, refractory celiac disease could be excluded. One patient with Marsh II lesions was fully compliant to his diet but had mistakenly taken an antibiotic containing gluten. Two patients showed lactose malabsorption, one patient showed Giardia lamblia and one patient Ascaris lumbricoides infestation, and 10 patients showed small intestinal bacterial overgrowth (SIBO) by lactulose H2-BT. We prescribed a diet without milk or fresh milk-derived foods to the patient with lactose malabsorption; we treated the patients with parasite infestation with mebendazole 500 mg/day for 3 days for 2 consecutive wk; and we treated the patients with SIBO with rifaximin 800 mg/day for 1 wk. The patients were re-evaluated 1 month after the end of drug treatment (or after starting lactose-free diet); at this visit all patients were symptom-free. CONCLUSIONS: This study showed that SIBO affects most celiacs with persistence of GI symptoms after gluten withdrawal.

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Matilda Enthusiast

..

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RiceGuy Collaborator

Thanks from me also.

It just backs up what I've been wondering about, since I still have certain symptoms. Though I haven't eliminated all dairy proteins and soy yet. I also just found out my shampoo has barley extract :(

Symptom free sure sounds nice, but I won't take no drugs. I'll still go the natural route, which I know works from past experience.

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Claire Collaborator
Thanks, Claire, this is really interesting. Do you think it's support for probiotics?

Matilda

Yes, I think so. Also think L-Glutamine would be a good way to go. About 5 grams a day. Claire

Thanks from me also.

It just backs up what I've been wondering about, since I still have certain symptoms. Though I haven't eliminated all dairy proteins and soy yet. I also just found out my shampoo has barley extract :(

Symptom free sure sounds nice, but I won't take no drugs. I'll still go the natural route, which I know works from past experience.

Note comments t Matilda. Good for you as well. Claire

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bluelotus Contributor

Wow, this may explain my recent hospitalization for bacterial overgrowth....as I had suspected, though my doctors had doubts (doctors seem to be the most un-scientific people I have ever meet - if its not in a textbook or they hadn't heard it before, its impossible......that ideology does not apply well to biological systems and if they just considered what celiac disease does to the intestinal tract, toxic bacterial overgrowth seems like a possible side effect. I hate doctors.)

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