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  • Jefferson Adams
    Jefferson Adams

    A Gluten-Free Diet Does Not Seem to Improve Autism Spectrum Disorders

    Reviewed and edited by a celiac disease expert.

    A randomized, controlled, single-blinded trial shows no functional differences between in children with autism spectrum disorders who eat a gluten-free diet and those who eat gluten-containing diet. 

    A Gluten-Free Diet Does Not Seem to Improve Autism Spectrum Disorders - Image: CC BY 2.0--QUOI Media
    Caption: Image: CC BY 2.0--QUOI Media

    Celiac.com 11/18/2019 - So far, the little research that's been done suggests that a gluten-free diet does not help to improve to improve the functioning of children with autism spectrum disorders. 

    A team of researchers recently conducted a randomized, controlled, single-blinded trial to see if children with autism spectrum disorders showed any difference in functioning on a gluten-free diet compared with a gluten-containing diet.



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    The research team included Anna Piwowarczyk, Andrea Horvath, Ewa Pisula, Rafał Kawa, and Hania Szajewska. They are variously affiliated with the Department of Pediatrics with Clinical Assessment Unit at The Medical University of Warsaw in Warsaw, Poland; the Department of Pediatrics at The Medical University of Warsaw in Warsaw, Poland; and the Department of Health and Rehabilitation Psychology, Faculty of Psychology at the University of Warsaw in Warsaw, Poland.

    Their team assessed a total of sixty-six children with autism spectrum disorders, within normal IQ range, above  70, who had been on a gluten-free diet for at least two months before enrollment. 

    After continuing a gluten-free diet for two-months, the gluten-free diet group continued this diet, while the gluten-containing diet group consumed at least one normal meal containing gluten per day for 6 months. 

    At the end of the trial period, the two groups showed no differences in autistic symptoms, maladaptive behaviors, or intellectual abilities. In this study, children with autism spectrum disorders eating a gluten-free diet did not show any significant signs of improved functioning compared with those who ate a gluten-containing diet.

    These results confirm the results of an earlier, similar study from 2015.

    So, the takeaway here is that a gluten-free diet does not improve functionality in patients with autism spectrum disorder.

    Read more at: Journal of Autism & Developmental Disorders, October 2019

    Edited by Jefferson Adams



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    There's a major flaw with this study: the researchers who did this study excluded autistic children with celiac disease, autistic children with wheat allergy, and autistic children with "presence of disease influencing behavior, feeding, or growth," which would of course include non-celiac gluten intolerance.

    In other words, they deliberately excluded all the autistic children who would benefit from a gluten-free diet, and then concluded, INCORRECTLY, that autistic children don't benefit from a gluten-free diet.

    This is especially disturbing because it's a major step backwards to the days when parents were told "your autistic child doesn't REALLY have intestinal problems, he's just acting like that because that's what children with autism do."

    Some children with autism benefit from a gluten-free diet.  Some don't.  Why is there an effort to turn it into a yes-or-no question for all children with autism?

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    Guest Father of gluten-free autistic son

    Posted

    Our son used to act 'high' all the time and smelled of bile all the time because he would regurgitate his food (like Mac and cheese) because his gut, according to the doctor, turned gluten into an opioid.

    We put him on the gluten-free diet and saw no results after 6 months. We decided to persist. After 9 months, we thought we saw

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    I did not read this full study, but unless the children were placed room and monitored by study staff 24 hours a day,  there is no way they can determine whether or not the children were actually gluten free.  Dietary studies, even if randomized, are notorious for collected false information because participants choose not to report accurately.  

    I just had a cousin who participated in a university food study this year.    She cheated and told us she was not going to report the food she ate.  The rest of us were shocked and dismayed.   

    As a celiac, I meet lots of people who think they are actually gluten free, but they make classic mistakes.  I went to Poland a few years ago.   There was very little awareness of celiac disease.  I am sure awareness is improving, and there were some gluten free foods available imported like Germany found in stores.  

    https://celiakia.pl/for-visitors-with-coeliac-disease/

    I bet those kids still had access to gluten, most likely due to cross contamination.  It takes most celiacs up to a year to heal because the gluten free diet has a very steep learning curve!  

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  • About Me

    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,500 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.


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  • Related Articles

    Jefferson Adams
    Celiac.com 07/08/2009 - Kids whose moms have autoimmune diseases such as type 1 diabetes, rheumatoid arthritis and celiac disease face a risk of autism that is up to three times higher than that of the general population, according to a new study.
    Although earlier studies have documented a connection between autism and a maternal history of type 1 diabetes and rheumatoid arthritis, this is the first study to document a link between autism and celiac disease, according to the study's authors.
    A team of researchers led by Dr. William W. Eaton, chairman of the Department of Mental Health at the Bloomberg School of Public Health at Johns Hopkins University recently set out to review data related to autoimmune deficiency and autism.  
    Eaton's team collected data on 3,325 Danish children diagnosed with autism spectrum disorder, including 1,089 diagnosed with infantile autism. All of the children were born between 1993 and 2004, and their data was part of the Danish National Psychiatric Registry. Data on family members with autoimmune diseases came from the Danish National Hospital Register.
    The data showed that children whose mothers had autoimmune disease faced a higher risk of developing autism spectrum disorder than children of mothers who did not have these conditions. Moreover, children with a family history of type 1 diabetes faced an increased risk of infantile autism.
    Overall, the increased risk of autism in people with autoimmune diseases is not huge, Eaton said. "The increased risk for type 1 diabetes is a little less than two times, for rheumatoid arthritis it's about 1.5 times and for celiac disease it's more than three times," Eaton said. "That's enough to impress an epidemiologist, but not enough to make anybody in the general population start changing their behavior."
    Eaton added that this finding "reinforces the suggestion that autoimmune processes are connected somehow with the cause of autism and autism spectrum disorder, and...may point a flashlight to areas of the genome that connect to autism."
    The finding itself has no clinical significance, says Eaton, but could guide future efforts by researchers to determine the cause or causes of autism.
    One reason autoimmune diseases might have a role in autism lies in genetic history, Eaton said. Children who were underweight or premature at birth face a higher risk for autism, and both of these obstetric problems are associated with celiac disease, he added.
    There may be a significant overlap "in the genetics of some of the autoimmune diseases and autism," he said. "Autism is strongly inherited, but we don't have the faintest idea where...this finding is on the pathway of finding the cause of autism." Various environmental triggers may also affect the fetus, he said.
    Lead researcher, Dr. Hjordis O. Atladottir, from the Institute of Public Health at the University of Aarhus in Denmark calls the findings important because they support the theory that autism is somehow tied to problems with the immune system.

    PEDIATRICS



    Jefferson Adams
    Celiac.com 09/21/2015 - A gluten-free diet does nothing to improve behaviors or symptoms of children with autism, according to the results of a study that, though small, is being called the most comprehensive and carefully controlled diet research in autism to date. The study results appear in the Journal of Autism and Developmental Disorders.
    The study was conducted by Dr. Susan Hyman and colleagues at the University of Rochester Medical Center. Dr, Hyman is the division chief of neuro-developmental and behavioral pediatrics at the University of Rochester's Kirch Developmental Services Center, which sees some 1,200 children with autism each year.
    For the study, a group of preschool children with Autism Spectrum Disorders (ASD) received a gluten-free, casein-free (Gluten-free Casein-free) diet.
    Hyman's study enrolled 22 children between 2 ½- and 5 ½-years-old. Fourteen children completed the intervention, which was planned for 18 weeks for each family. The families had to strictly adhere to a gluten-free and casein-free diet and participate in early intensive behavioral intervention throughout the study. Children were screened for iron and vitamin D deficiency, milk and wheat allergies and celiac disease. One child was excluded because of a positive test for celiac disease and one was excluded for iron deficiency. Other volunteers who were excluded were unable to adhere to the study requirements. The children's diets were carefully monitored throughout the study to make sure they were getting enough vitamin D, iron, calcium, protein and other nutrients.
    After four weeks of being established on diet, the children continued on the diet and were given snacks weekly that contained gluten, casein, neither or both.
    In addition to administering a gluten-free casien-free diet, the research team received a full complement of nutrients, such as vitamin D, calcium, iron and high quality protein, which can be lacking in children on gluten-free, casein-free diets.
    The kids were given a snack once weekly with either 20 grams of wheat flour, 23 grams of non-fat dried milk, both, or neither until every child received each snack three times. Snacks were carefully engineered to look, taste and feel the same, and were given randomly with no knowledge by staff, families or children.
    Parents, teachers and a research assistant filled out standardized surveys about the child's behavior the day before they received the snack, at two and 24 hours after the snack.
    However, none of the diet and snack combinations affected children's sleep, bowel habits, or activity.

    The team did observe a small increase in the number of times children engaged in social interaction after eating food containing gluten or casein, but this increase did not reach statistical significance. A similar small increase in social language seen after the gluten challenge also did not reach statistical significance.
    The team cites the need for larger studies that appropriately monitor for diet and other interventions to determine whether gluten or casein affects social interaction or language among other children with ASD, such as children with gastrointestinal (GI) disease.
    For families who wish to eliminate gluten and casein from their child's diet need, the team points out the importance of carefully monitoring the autistic child's nutritional status.
    Sources:
    URMC Rochester URMC Rochester News Journal of Autism and Developmental Disorders Department of Pediatrics and Clinical Research Center, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, New York
    Research Supported By: National Institutes for Mental Health (Studies to Advance Autism Research in Treatment) NIMH U54 MH077397 and the National Center for Research Resources (NCRR) NIH UL1RR024160


    Dr. Ron Hoggan, Ed.D.
    Celiac.com 11/23/2017 - Many theories have been fielded about autism. Some research careers have been made by investigating autism, while other careers have been seriously damaged when that research threatened some sacred cows of allopathic medicine. Yet despite all of this active research exploring the world of autism, we continue to experience exponential increases in rates at which autism is diagnosed. And debate continues unabated regarding the causes and appropriate treatments. Part of this increasing trend is, doubtless, because we have gotten better at recognizing the various manifestations of this debilitating condition. However, the evidence indicates that there is a dramatic increase in the absolute incidence of autism. Although frightening, this trend may offer some insight into several of the factors that contribute to this condition. That is the crux of my argument here. Since most prior theories have been tested in isolation, as is the norm in medical investigations, measurement of changes induced by individual contributing factors may either be so mild as to escape notice, or may not have been sufficient to induce symptom mitigation. Similarly, if preconceived notions shape resistance to some of these hypotheses, we may miss the most salient characteristics of autism. I have therefore chosen to combine several findings to form a testable hypothesis. I'll let posterity and the reader be the judges of whether this speculation is worthy of further investigation.
    We begin with Dr. Kalle Reichelt, who sought to understand autism and other psychiatric illnesses through the prism suggested by Dr. Curtis Dohan's work investigating schizophrenic patients. While Dohan et al reported positive results among schizophrenics from a gluten free, dairy free diet, Reichelt and his colleagues identified unique peptides in the urinary excretions from patients on the autistic spectrum and explored their possible connections with gluten and dairy proteins(1). A leaky gut appeared to be a precondition for autism. In 1996, D'Eufemia and others reported increased intestinal permeability in almost half of their autistic patients, using synthetic sugars that can be measured in the urine (2). Gardner has reported disturbed gastrointestinal function in autism.
    Reichelt and Knivsberg have also published reports of improved social interaction and communication among some children with autism following institution of a gluten-free, casein-free diet (4). However, their investigations reveal that the diet must be consistent, strict, and long-lasting to allow the gradual dissipation of the psychoactive peptides from these foods. Others have reported that this dissipation process can take up to 12 months (5).
    It is important to note that, while the work indicating that the symptoms of autism can often be mitigated by the strict, long-term avoidance of gluten and dairy, none of these investigators claimed that this diet can cure autism or even eliminates all of its symptoms. The diet simply helped children improve to the point where they could function better in school and society by mitigating their most severe and limiting symptoms (4). Many of these researchers postulate that improved integrity of the intestinal barrier and reduced ingestion of psychoactive peptides in the diet are a likely root of these improvements.
    Against this backdrop of widespread recognition of gastrointestinal dysfunction, excessive intestinal permeability, and symptom mitigation through dietary restriction in many autistic children, Dr. Andrew Wakefield, along with 12 other researchers, published their discovery of a pattern of intestinal inflammation and compromised barrier function in 11 of 12 subjects with pervasive developmental disorders, including 9 children with autism.
    Based on histories provided by parents, health visitors, and general practitioners, a pattern of behavioral/autistic symptom onset was seen within 14 days of combined vaccination for measles, mumps, and rubella. The average time to symptom onset was about 6 days. In the same report, Wakefield et al state "We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described." Later on the same page, they state "If there is a causal link between measles, mumps, and rubella vaccine and this syndrome, a rising incidence might be anticipated after the introduction of this vaccine in the UK, in 1988." [my emphasis] Wakefield et al identify several reports connecting vaccine-strain measles virus with Crohn's disease and autoimmune hepatitis. They also hearken to earlier work that implicates inflamed or dysfunctional intestines in the behavior changes seen in some children. They point to other factors that suggest a genetic predisposition may also be a precondition of developing autism, along with markers of vitamin B12 deficiency (which many readers will recognize as a common finding in celiac disease and non-celiac gluten sensitivity). Clearly this group was not attacking the MMR vaccine or its importance to public health. Nonetheless, in the same issue of The Lancet, no less than six letters, written by a combined total of 21 authors, attacked Wakefield et al because of the impact that their findings might have on public health.
    Over the ensuing months and years, Wakefield's methods were criticized and denigrated. One of the more emotional attacks alleged academic fraud on Wakefield's part (7). He has been vilified in the public and professional media as a brigand. Yet he and his research group were careful to avoid making any claims beyond having found a form of bowel disease (lymphoid hyperplasia) in 9 of their subjects, and non-specific colitis in 11 of their subjects, along with reporting the close temporal association of onset of behavioral symptoms and MMR vaccines as reported by parents, health visitors, and general practitioners. They would have been remiss had they failed to report this association. Further, there were 12 other researchers who put their names to this research. Surely we cannot suspect that all 13 of these professionals would risk their careers to perpetrate a fraud!
    Meanwhile, as these attacks were ginning up, a research group at the University of Maryland reported that, in genetically susceptible individuals, a protein they dubbed "zonulin" can, when gluten is ingested, induce changes to intestinal permeability (8, 9). Does the gluten free, dairy free diet reduce excessive intestinal permeability? We know it does in people with celiac disease (8), but what impact would or could it have on children with the lymphoid hyperplasia and/or non-specific colitis identified by Wakefield et al? And does reduced zonulin production due to restriction of these foods explain the benefit experienced by many children with autism?
    Perhaps these questions are also relevant to another area of autism research reflected by identification of specific strains of clostridium infection in autism, first postulated by Bolte (10). Dr. S. Finegold and his colleagues demonstrated that 8 of 10 children with late onset autism showed transient reductions of symptoms of autism in response to oral vancomycin which returned when vancomycin was withdrawn (11). This is an antibiotic that is usually used in cases of antibiotic-resistant infections. Because this group identified an unusually large number and variety of strains of clostridium in their autistic subjects, as compared with controls, and because many clostridium variants excrete neurotoxic substances, their use of vancomycin was given to target clostridium.
    However, elements of Finegold's work and Wakefield's work may be taken to suggest some overlap. For instance, could the added clostridium load in autistic children contribute to the intestinal inflammation and permeability seen in Wakefield's report? Or could the MMR vaccinations produce conditions that are more hospitable to antibiotic resistant, neurotoxic strains of clostridia? Or could symptoms induced by MMR lead to administration of antibiotics that provide favorable conditions in the gut for proliferation of clostridium?
    To further complicate this issue, Dr. Stephanie Seneff has identified vitamin D deficiency, and popular use of statin drugs, in combination with reduced dietary consumption of cholesterol and fats as possible factors in autism. She implicates these deficiencies as arising either in utero or in infancy and she specifically cites work demonstrating that cholesterol, fats, and vitamin D are important components of healthy immune function (14).
    Putting it all together
    The hypothesis embodied herein asserts that at some stage the autistic child has: some predisposition to autism; a multi-dimensionally compromised immune system; been exposed to multiple and uncommon strains of clostridium which lead to the colonization of the gut by these antibiotic-resistant bacteria; are suffering from some degree of vitamin D deficiency and are eating a diet that is deficient in fats and cholesterol. Further, as the child develops one or more of the symptoms or sequelae of clostridium colonization or other infection, antibiotics are administered to provide relief from these or other symptoms of infection, sometimes including chronic ear infections. Thus, the competing gut bacteria that might otherwise keep these strains of clostridia in check are wiped out, permitting broader proliferation of multiple strains of clostridia.
    Similarly, the MMR vaccine, which, by design, engages and taxes the immune system. In the immune system's weakened state resulting from vaccination and dietary opioids (13), increased numbers of unusual strains of clostridium, abnormal gut biome, cholesterol deficiency, vitamin D deficiency, and perhaps, other nutrient deficiencies, also reduces systemic surveillance for, and antibody combat with, the clostridia and/or remnants of MMR vaccine. The neurotoxic excreta from clostridia and MMR are released into the intestinal lumen and by zonulin's action to widen the junctions between epithelial cells, these toxins are thus given access to the bloodstream. By the same pathway, opioids, other psychoactive peptides from gluten and dairy, along with other undigested and partly digested proteins, which may be harmful, also reach the bloodstream. From there, they travel to the BBB where zonulin again opens gaps in this barrier and allows the clostridium-derived toxins, opioids, and other impurities access to the brain where they alter blood-flow patterns, damage neurological tissues, and perhaps do other damage that has not yet been recognized. Ultimately, this damage and dynamics lead to impeded social performance, intellectual performance, and sometimes, induce startlingly abnormal behaviors.
    Although this picture appears bleak, and much of it simply reflects the several dietary miscues of the last and our current century, there are corrective steps that can sometimes improve these children's lives. Vitamin D, vitamin B12, and other supplements can be administered to address deficiencies. Because of the associated gut problems, sub-lingual vitamins, and exposure to sunlight without sun screen may both be good starting points. A strict, long-term gluten free, dairy free diet should also be on the menu, even if the whole family has to follow it to ensure that the autistic child does not rebel due to feeling deprived. High levels of cholesterol, saturated and mono-unsaturated fats should also comprise a large part of the diet. One or more courses of vancomycin may also be worth trying. In isolation, the benefits of antibiotics alone will likely be short-lived, as reported by Finegold, but in combination with these other strategies, may extend the benefits of this drug. New developments in antibiotics research may lead to isolation of protective substances from hens' egg shells that may provide more appropriate antibiotic relief and therefore benefit these children even more (15).
    Most of the research, to date, has focused on one of these factors in isolation. However, if an immune system is compromised by any or all of cholesterol deficiency, vitamin D deficiency, vitamin B12 deficiency, dietary shortages of cholesterol and fats, lingering, chronic sequelae of MMR vaccination, opioids from gluten and/or dairy, and an unusual and wide variety of clostridia, then it seems unreasonable to expect to reverse this condition through implementing only one of the interventions suggested by the above. Each and all of these other components should be addressed when attempting to remediate autism. In the context of these dietary and lifestyle changes, appropriate antibiotics may lead to more permanent improvements for the autistic child. This would be the greatest gift that a physician, parent, or caretaker could give to these children. One may hope.
     
    References:
    Reichelt KL, Hole K, Hamberger A, Saelid G, Edminson PD, Braestrup CB, Lingjaerde O, Ledaal P, Orbeck H. Biologically active peptide-containing fractions in schizophrenia and childhood autism. Adv Biochem Psychopharmacol. 1981;28:627-43. D'Eufemia P, Celli M, Finocchiaro R, Pacifico L, Viozzi L, Zaccagnini M, Cardi E, Giardini O. Abnormal intestinal permeability in children with autism. Acta Paediatr. 1996 Sep;85(9):1076-9. Gardner MLG (1994) in Physiology of the gastrointestinal tract (Johnson LR : edit) Rave Press, NY pp 1795-1820 Knivsberg AM, Reichelt KL, Høien T, Nødland M. A randomised, controlled study of dietary intervention in autistic syndromes. Nutr Neurosci. 2002 Sep;5(4):251-61. Paul, K., Henker, J., Todt, A., Eysold, R. (1985) Zoeliaki- Kranken Kindern in Abhaengigkeit von der Ernaehrung Seitschrift der Klinische Medizin 40; 707-709. as reported in Reichelt K (1990). The Effect of Gluten-Free Diet on Urinary Peptide Excretion and Clinical State in Schizophrenia. Journal of Orthomolecular Medicine. 5(4): 223-239. Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, Berelowitz M, Dhillon AP, Thomson MA, Harvey P, Valentine A, Davies SE, Walker-Smith JA. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet. 2004 Mar 6;363(9411):750. Flaherty DK. The vaccine-autism connection: a public health crisis caused by unethical medical practices and fraudulent science. Ann Pharmacother. 2011 Oct;45(10):1302-4. Epub 2011 Sep 13. Fasano A, Not T, Wang W, Uzzau S, Berti I, Tommasini A, Goldblum SE. Zonulin, a newly discovered modulator of intestinal permeability, and its expression in coeliac disease. Lancet. 2000 Apr 29;355(9214):1518-9. Clemente MG, De Virgiliis S, Kang JS, Macatagney R, Musu MP, Di Pierro MR, Drago S, Congia M, Fasano A. Early effects of gliadin on enterocyte intracellular signalling involved in intestinal barrier function. Gut. 2003 Feb;52(2):218-23. Bolte ER. Autism and Clostridium tetani. Med Hypotheses. 1998 Aug;51(2):133-44. Finegold SM, Molitoris D, Song Y, Liu C, Vaisanen ML, Bolte E, McTeague M, Sandler R, Wexler H, Marlowe EM, Collins MD, Lawson PA, Summanen P, Baysallar M, Tomzynski TJ, Read E, Johnson E, Rolfe R, Nasir P, Shah H, Haake DA, Manning P, Kaul A. Gastrointestinal microflora studies in late-onset autism. Clin Infect Dis. 2002 Sep 1;35(Suppl 1):S6-S16. http://stephanie-on-health.blogspot.ca/2008/11/sunscreen-and-low-fat-diet-recipe-for.html  Hoggan R. Considering wheat, rye, and barley proteins as aids to carcinogens. Med Hypotheses. 1997 Sep;49(3):285-8 Seneff S, Davidson R, Mascitelli L. Might cholesterol sulfate deficiency contribute to the development of autistic spectrum disorder? Med Hypotheses. 2012 Feb;78(2):213-7. Epub 2011 Nov 17. Wellman-Labadie O, Lakshminarayanan R, Hinckeemail MT Antimicrobial properties of avian eggshell-specific C-type lectin-like proteins. FEBS Letters Volume 582, Issue 5 , Pages 699-704, 5 March 2008 Additional Resources:
    https://www.autismparentingmagazine.com/best-supplements-vitamins-autism/


    Jefferson Adams
    Celiac.com 10/08/2018 - A new population based study reveals that celiac disease is associated with a wide range of medical conditions, including liver disease, glossitis, pancreatitis, Down syndrome, and autism, according to a database study of more than 35 million people.
    Moreover, people with autism have celiac disease at rates almost 20 times higher than in those without autism, reported lead investigator Daniel Karb, MD, a second-year resident at University Hospitals Case Medical Center in Cleveland. That raises the question of whether people with autism should be screened for celiac disease, and whether they might benefit form a gluten-free diet.
    "If you have a patient who is autistic and they have all these unusual symptoms, you might want to screen them for celiac disease," Dr. Karb told the World Congress of Gastroenterology last year. It is known that there are unusual symptoms of celiac disease, which include anything outside the classic symptoms of malabsorption, steatorrhea, malnutrition, abdominal pain, and cramping after eating, "but this is putting numbers to it," said Dr Karb.
    For their study, Karb and his fellow researchers used the Explorys database to pull health record data from 26 major integrated healthcare systems in the United States. Their search covered the period from 2012 to 2017. Of 35,854,260 people in the database, they found 83,090 with diagnosed celiac disease.
    Overall, the age-adjusted prevalence of celiac disease in that group was 0.22%, which is much lower than the 1% to 2% range previously estimated.
    Those numbers are not unusual, said Dr. Karb says that the researchers “don't think there are fewer people with celiac disease, just that it may be under-diagnosed.” The rates are, he says, “what you might expect when you screen asymptomatic people." 
    Overall, the team found a significant connection between celiac disease and 13 other autoimmune disorders, such as type 1 diabetes, Crohn's disease, and ulcerative colitis. Moreover, celiac disease is associated with every autoimmune disease the team looked at, except for primary biliary cholangitis, Dr Karb says.
    This is some pretty startling study data. We knew that celiac disease was linked to other autoimmune conditions, and there has been some surprising data about gluten-free diets helping patients with autism, but these numbers are enlightening. It seems that people with autism should definitely be screened for celiac disease, and placed a gluten-free diet, if tests confirm celiac disease.
    Stay tuned for more information on this important celiac disease topic.
    Source:
     World Congress of Gastroenterology 2017


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