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    The Restless Leg Syndrome, SIBO, Celiac Connection


    Jefferson Adams

    Celiac.com 09/03/2009 - Every night thousands of people lose sleep because of a gnawing, tingling urge to move their legs, disturbing their sleep and are often causing chronic pain. These people wake feeling unrested, with aching muscles.


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    In addition to lost sleep and discomfort, these people often suffer chronic pain. Often, these symptoms baffle both patients and primary care doctors. Little do these people and their doctors know that the pain and restlessness is due to Restless Legs Syndrome (RLS) and is likely caused by a problem with the digestive tract.

    RLS affects 7% to 15% of the population, especially older adults and pregnant women. RLS symptoms can have a major impact on quality of life, and the syndrome often stymies the medical community. In recent years a number of drugs have been introduced to help the symptoms of RLS, but until now the cause has remained unknown.

    Small intestinal bacterial overgrowth (SIBO) is a condition where abnormally large numbers of bacteria exist in the small intestine. Symptoms often include diarrhea, bloating, excess gas and abdominal pain. SIBO has strong ties to IBS, diabetes, celiac disease and Crohn’s disease.

    St. Louis-based Gastroenterologist Dr. Leonard Weinstock has led research that has recently established a link between RLS and SIBO. Dr. Weinstock's clinical trials have shown that treating SIBO often sends the RLS into remission.

    “When a patient was diagnosed with SIBO, given a course of treatment that included rifaximin, an antibiotic that is not absorbed by the bloodstream, we found that the patient showed quick, dramatic and continuing relief of RLS symptoms,” explains Weinstock.

    This discovery promises a new lease on life for many RLS sufferers. Weinstock discovered the association while treating a patient for Irritable Bowel Syndrome (IBS) who also suffered from RLS. Treatment of the IBS, also seemed to send the patient’s RLS into remission. This discovery led to a number of trials, all of which produced the same overall result.

    “While many new drugs help treat the symptoms of RLS. This research shows us the cause of the disease and in turn allows us to treat the RLS rather than just helping the symptoms,” says Weinstock.

    Based on a standard RLS severity scale, all Weinstock’s patients have shown substantial improvement. In the most recent trial, severity scores for 9 of 14 patients dropped an average of 65% after one course of antibiotics. After an initial lack of response, two patients received a second round of antibiotics and no longer had any symptoms. A third patient was cured after discovering that she had celiac disease and beginning on a gluten-free diet.

    The link between non-responsive celiac disease and SIBO has also been documented. The fact that such a link exists between SIBO and RLS, and other conditions such as celiac disease, IBS and Crohn’s disease clearly warrants further study, and should give anyone suffering from RLS some information to share with their clinician in approaching the issue.

    Source:

    http://www.pitchengine.com/specialistsingastroenterologyadvancedendoscopycenter/sending-restless-legs-syndrome-rls-into-remission/21146/


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    Guest Javier BaRa

    Posted

    I just KNEW there had to be a link between gut/gluten problems & RLS. Wish you had a link for Dr. Leonard Weinstock, tho' I can Google his site. Needless to say, there are other natural ways to properly restore flora balance. As he's using antibiotics, leads me to think that there's a problem with H-pylori as well.

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    Guest Kerstin RIos

    Posted

    I was recently diagnosed with ulcers in my small bowel and which caused iron deficient anemia. Since taking iron pills I have not had RLS which was getting really, really bad.

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    Guest Deborah Allen

    Posted

    I'd like to see more research on this and on the particular antibiotic rifaximin. No doc has ever prescribed that for me. I have had Rx for h-pylori (prevpak) and I can't say that I noticed any relief from rls at the times I have taken it.

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    Guest Kit Kellison

    Posted

    I was in Dr. Weinstock's study and I agree that SIBO can be responsible for many problems associated with celiac, Crohn's and other autoimmune diseases which may create a spectrum of nervous system disorders.

     

    What I dislike, however, is the lack of mention of the Specific Carbohydrate Diet. It's obvious that Xifaxim is only a temporary solution, and should at least be followed up by a strict Specific Carbohydrate Diet. Elimination of SIBO, for most people, just isn't going to happen without it.

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    Guest Judy Gerardi

    Posted

    My son alerted me to this site and as I have had RLS all my life I never ever thought about diet, other than coffee, etc. I will look into this more and will try Probiotics.

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    Scott Adams
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    Scott Adams
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    Dig Dis Sci. 2006 Sep 12
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    Tursi A, Giorgetti GM, Iani C, Arciprete F, Brandimarte G, Capria A, Fontana L.
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    Jefferson Adams
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    Jefferson Adams
    Celiac.com 04/23/2015 - It's well-known that many people with celiac disease experience neuropathy and other nerve disorders. Now, a team of Israeli researchers are cautiously proposing a link between gluten reactions and ALS.
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    Drory said her team has begun to study TG6 antibody levels in patients newly diagnosed with ALS, and they will be testing the effects of a gluten-free diet in some of those that test positive. However, theirs is just one report, and Drory expects it will be at least a couple of years before the team has any solid results. Her team is also inviting further input from other centers, and study of their data.
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    Source:
    JAMA Neurol. 2015 Apr 13. doi: 10.1001/jamaneurol.2015.48.

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    Jefferson Adams
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    Jefferson Adams
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    Dr. Ron Hoggan, Ed.D.
    Celiac.com 06/15/2018 - There seems to be widespread agreement in the published medical research reports that stuttering is driven by abnormalities in the brain. Sometimes these are the result of brain injuries resulting from a stroke. Other types of brain injuries can also result in stuttering. Patients with Parkinson’s disease who were treated with stimulation of the subthalamic nucleus, an area of the brain that regulates some motor functions, experienced a return or worsening of stuttering that improved when the stimulation was turned off (1). Similarly, stroke has also been reported in association with acquired stuttering (2). While there are some reports of psychological mechanisms underlying stuttering, a majority of reports seem to favor altered brain morphology and/or function as the root of stuttering (3). Reports of structural differences between the brain hemispheres that are absent in those who do not stutter are also common (4). About 5% of children stutter, beginning sometime around age 3, during the phase of speech acquisition. However, about 75% of these cases resolve without intervention, before reaching their teens (5). Some cases of aphasia, a loss of speech production or understanding, have been reported in association with damage or changes to one or more of the language centers of the brain (6). Stuttering may sometimes arise from changes or damage to these same language centers (7). Thus, many stutterers have abnormalities in the same regions of the brain similar to those seen in aphasia.
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    Whatever the reason that stuttering has not been reported in the medical literature in association with gluten ingestion, a number of personal disclosures and comments suggesting a connection between gluten and stuttering can be found on the Internet. Abid Hussain, in an article about food allergy and stuttering said: “The most common food allergy prevalent in stutterers is that of gluten which has been found to aggravate the stutter” (10). Similarly, Craig Forsythe posted an article that includes five cases of self-reporting individuals who believe that their stuttering is or was connected to gluten, one of whom also experiences stuttering from foods containing yeast (11). The same site contains one report of a stutterer who has had no relief despite following a gluten free diet for 20 years (11). Another stutterer, Jay88, reports the complete disappearance of her/his stammer on a gluten free diet (12). Doubtless there are many more such anecdotes to be found on the Internet* but we have to question them, exercising more skepticism than we might when reading similar claims in a peer reviewed scientific or medical journal.
    There are many reports in such journals connecting brain and neurological ailments with gluten, so it is not much of a stretch, on that basis alone, to suspect that stuttering may be a symptom of the gluten syndrome. Rodney Ford has even characterized celiac disease as an ailment that may begin through gluten-induced neurological damage (13) and Marios Hadjivassiliou and his group of neurologists and neurological investigators have devoted considerable time and effort to research that reveals gluten as an important factor in a majority of neurological diseases of unknown origin (14) which, as I have pointed out previously, includes most neurological ailments.
    My own experience with stuttering is limited. I stuttered as a child when I became nervous, upset, or self-conscious. Although I have been gluten free for many years, I haven’t noticed any impact on my inclination to stutter when upset. I don’t know if they are related, but I have also had challenges with speaking when distressed and I have noticed a substantial improvement in this area since removing gluten from my diet. Nonetheless, I have long wondered if there is a connection between gluten consumption and stuttering. Having done the research for this article, I would now encourage stutterers to try a gluten free diet for six months to see if it will reduce or eliminate their stutter. Meanwhile, I hope that some investigator out there will research this matter, publish her findings, and start the ball rolling toward getting some definitive answers to this question.
    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

    Jefferson Adams
    Celiac.com 06/14/2018 - Refractory celiac disease type II (RCDII) is a rare complication of celiac disease that has high death rates. To diagnose RCDII, doctors identify a clonal population of phenotypically aberrant intraepithelial lymphocytes (IELs). 
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    They also noted a higher frequency of surface CD3(−) IELs in cases with clonal TCR-GR, but the PCP pattern showed no associations with any clinical or pathological feature. 
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    Source:
    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023

    Jefferson Adams
    Celiac.com 06/13/2018 - There have been numerous reports that olmesartan, aka Benicar, seems to trigger sprue‐like enteropathy in many patients, but so far, studies have produced mixed results, and there really hasn’t been a rigorous study of the issue. A team of researchers recently set out to assess whether olmesartan is associated with a higher rate of enteropathy compared with other angiotensin II receptor blockers (ARBs).
    The research team included Y.‐H. Dong; Y. Jin; TN Tsacogianis; M He; PH Hsieh; and JJ Gagne. They are variously affiliated with the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School in Boston, MA, USA; the Faculty of Pharmacy, School of Pharmaceutical Science at National Yang‐Ming University in Taipei, Taiwan; and the Department of Hepato‐Gastroenterology, Chi Mei Medical Center in Tainan, Taiwan.
    To get solid data on the issue, the team conducted a cohort study among ARB initiators in 5 US claims databases covering numerous health insurers. They used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for enteropathy‐related outcomes, including celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy. In all, they found nearly two million eligible patients. 
    They then assessed those patients and compared the results for olmesartan initiators to initiators of other ARBs after propensity score (PS) matching. They found unadjusted incidence rates of 0.82, 1.41, 1.66 and 29.20 per 1,000 person‐years for celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy respectively. 
    After PS matching comparing olmesartan to other ARBs, hazard ratios were 1.21 (95% CI, 1.05‐1.40), 1.00 (95% CI, 0.88‐1.13), 1.22 (95% CI, 1.10‐1.36) and 1.04 (95% CI, 1.01‐1.07) for each outcome. Patients aged 65 years and older showed greater hazard ratios for celiac disease, as did patients receiving treatment for more than 1 year, and patients receiving higher cumulative olmesartan doses.
    This is the first comprehensive multi‐database study to document a higher rate of enteropathy in olmesartan initiators as compared to initiators of other ARBs, though absolute rates were low for both groups.
    Source:
    Alimentary Pharmacology & Therapeutics