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Celiac3270
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32954.1

from: St-Johns Listserv:

"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.

PMID: 12738465 [PubMed]"

Mireille, Waterloo, Quebec, gluten-free since dec. 97

Quite interesting, isn't it? Sounds quite promising that this is the answer. Can't hurt, can only help.....

Karen

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Perfect......that's similar to the article on celiac.com, but a little more detailed, which is good. Anyway, I think I have SIBO since I still have symptoms and I know that I'm SO cautious about foods, contamination, everything! I bet I have this, like I've said before. Thanks for the article :)

-celiac3270

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I said this under my bacterial overgrowth topic (post-diagnosis section), but I'm gonna show that article to my new celiac dr....I'm making a list of symptoms, explanations, and that article. Thanks again.

-celiac3270

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Hi celiac3270:

I have found some mega acidophillis (sp?) that is lactose free, from Natural Source. I like it in powder form, it actually tastes pretty good. I just wash it down with water....

I hope this is the answer for you - it certainly sounds like it from the articles....

I think it will help both you and I....

This is my second day going gluten/lactose/sugar/caffeine free, and I have to admit that I don't have nearly as much gas in my stomach and also it doesn't sound like the usual thunderstorm in there!!!!

Karen

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