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      Frequently Asked Questions About Celiac Disease   04/24/2018

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to Celiac.com's FREE weekly eNewsletter   What is Celiac Disease and the Gluten-Free Diet? What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease?  Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes
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    A GLUTEN FREE DIET MAY ALLEVIATE GASTROESOPHAGEAL REFLUX SYMPTOMS IN PEOPLE WITH CELIAC DISEASE


    Diana Gitig Ph.D.

    Celiac.com 12/16/2011 - To date, symptoms of gastroesophageal reflux disease (GERD) - heartburn and acid regurgitation - have been among the only GI symptoms absent from the list of common manifestations of celiac disease. They are usually definitive indicators of gastric acid reflux. But a report from Julio César Bai's group in Buenos Aires notes that at the time of diagnosis, patients with celiac disease were more likely to complain of GERD symptoms than healthy controls. Moreover, maintaining a gluten free diet alleviated these symptoms. Photo: CC - JudeanPeoplesFront.jpgTheir results are reported in Clinical Gastroenterology and Hepatology.GERD is a chronic condition usually resulting from the reflux of acidic stomach contents up into the esophagus. It is commonly treated with proton pump inhibitors, but some cases are refractory to this treatment. There has been conflicting data as to whether GERD symptoms are more common in people with celiac, and whether a gluten free diet might help. Dr. Bai's group designed a two pronged study to answer these questions: They undertook a cross sectional analysis of 133 people upon their diagnosis with celiac over the course of 2005, and a longitudinal assessment of 53 of them as they maintained a gluten free diet over the next four years.


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    At the time of their diagnosis, the proportion of celiac with reflux was six-fold higher than that in the the 70 healthy controls included in the study. Interestingly, more severe reflux symptoms were associated with the classical, rather than the silent, presentation of celiac disease. However, it should be noted that this was somewhat of a selected population; these data were obtained from patients coming to a malabsorption clinic, where the classic presentation of celiac is more prevalent than the silent type. Moreover, for whatever reason, these healthy volunteers had less GERD symptoms than is usually reported. After three months on a gluten free diet symptoms were comparable to those seen in healthy controls. Interestingly, though, this was the case for patients who reported only partially complying to a gluten free diet as well as those who adhered to it strictly.

    Because these symptoms are alleviated upon assumption of a gluten free diet, the authors hypothesize that they might be caused by a nontraditional mechanism in celiac patients rather than by actual reflux. One suggestion they posit is reduced upper gastrointestinal motility, and another is a permeability defect in the stratified esophageal epithelium. In an editorial accompanying the paper, delayed gastric emptying and disturbed neuroendocrine control of upper GI function are floated potentially contributing to GERD symptoms in untreated celiac. Further research would have to be done to bear out these and other ideas.

    Nachman F, Vázquez H, González A, Andrenacci P, Compagni L, Reyes H, Sugai E, Moreno ML, Smecuol E, Hwang HJ, Sánchez IP, Mauriño E, Bai JC. Gastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet. Clin Gastroenterol Hepatol. 2011 Mar;9(3):214-9. Epub 2010 Jun 30.

    Source:


    Image Caption: Photo: CC - JudeanPeoplesFront
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    Guest Joan Williams

    Posted

    I was diagnosed with celiac disease almost 33 years ago. I didn't have problems with GERD until 16 or 17 years ago. Have tried to go off med but in couple days dealing with GERD again.

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    Guest Lori Muir

    Posted

    Well, I can say for sure that yes, gluten caused my constant acid and/or constant belching. I have been through it all.

     

    First they said it was depression, (fibromyalgia, chronic fatigue, IBS, insomnia, migraines, hot flashes, nueralgia, lyme disease, ovaries need to come out, ... back to its all in my head and I now need bipolar drugs, basically they never believed how sick I really was...felt like I was dying or wanted to be dead!)

     

    .....and the meds made it (reflux, gerd, belching all of it) worse, (everytime)... so they put me on acid blockers, I was eating tums, and gas X daily... it still got worse; then a coating grew on my tongue...doc says they dont know what causes that exactly, for years they told me this, and I had to figure it out on my own!... ;

     

    It was the prescription acid blockers; After 12 years of being misdiagnosed with every syndrome under the sun; I was suffering from chronic malabsorbtion... this over stimulated or under-stimulated all of my endocrine glands, thyroid slowed down; had nodules all over it; I got fat and sick, and in even more excruciating joint (bone) pain (yea, they called that arthritis at 34!)... the parathyroid kept pumping out PTH like no tomorrow, (and they never checked that until I INSISTED ON IT) which pulled calcium right out of my bones...causing a parathyroid adenoma.

     

    By this time, the high PTH made my calcium way too high (10.2-10.8) plenty high for me; and my Vitamin D hit the floor at only 7-11! this also caused my BP to be high near the end, but it was low for years and I was not an athelete;, as well as high cholesterol; the good cholesterol was really good, the bad was really bad...

     

    I was belching 24-7, even laying in the bed in the morning upon waking, belch belch belch, all the way to the coffee pot; ... my stomach felt so bloated like I was 9 mos. prego all the time.

     

    I had the parathyroid ademoma removed with the minimally invasive radioguided technique; (don't get any other kind in my opinion MIRP or bust!) this immediately stopped the bone pain from leaching calcium; this also stopped the belching for the most part, but not completely..

     

    None of it was completely cured until I figured out that it was not only gluten I had intolerence to...it is also some forms of fructose..the double sugars in particular, like garlic, onions, mushrooms, cabbage family veggies; apples, pears, raisins, honey, etc.

     

    I am now following a LOW FODMAP food list and it is working wonderfully, when I remember to read ALL labels to ensure, no honey, no sugar free ingredients, no Xanthan gum, or any gluten dirivitive...and there are so many.

     

    FODMAP is an acronym for different food groups and how they break down into sugars. Seems I lack a certain enzyme to break down "double sugar" foods, like wheat and corn gluten; while regular sugar is fine...but the doubles will start the belching, bloating, arms and legs going numb, insomnia, and just feel puffy, tired, achy and depressed!

     

    For me, Its all about the VILLI..if damaged from food intolerences, you cant uptake nutrients from food, and digestiion does not work right at all... and you cant process what you have eaten; there is NO PILL TO FIX ANY OF THIS: diet changes are KEY; Good article, yes, its definitely related to food intolerance!! Read Dr. James Norman's new study on GERD and the parathryoid, (I participated in this one, may not be published yet)..

     

    I have gone a step further and linked the reason my (2 out of 4) parathyroids were bad...its all about the villi, chronic malabsorbtion will ruin your endrocrine system after years of eating all the wrong things (and pills make it even worse because they have cellulose and gluten fillers!! - MIRP surgery 4-27-11; only the bone pain and most (not all) of the belching/acid cured; went gluten free in July 2011; symptoms changed as my diet did, still had IBS but it was now different, and definatly related to fruits, as I was now aware of everything I was eating by going gluten free;

     

    I went low fodmap in September... this is heaven now, I am me again, what a journey! I feel light, never bloated, mind feels sharp, memory has improved greatly, along with energy, outlook, good sleep, and a bonus of a negative 40lbs! oh, yea,.....and no more IBS or migranes or high blood pressure, or high cholesterol, and I eat very well, anything I can dream up, as long as the ingredients are low in double sugars!!

     

    This was the easiest trade off in my life compaired to the hell the doctors and surgeons put me though! FOOD< who knew? Veneers for my teeth are the next step and the last to truly feel like myself again! I now feel like I did in high school, never thought it possible.

     

    Thank you all at Celiac.com... all the articles here are wonderful, such a life saver!

    Share this comment


    Link to comment
    Share on other sites
    Well, I can say for sure that yes, gluten caused my constant acid and/or constant belching. I have been through it all.

     

    First they said it was depression, (fibromyalgia, chronic fatigue, IBS, insomnia, migraines, hot flashes, nueralgia, lyme disease, ovaries need to come out, ... back to its all in my head and I now need bipolar drugs, basically they never believed how sick I really was...felt like I was dying or wanted to be dead!)

     

    .....and the meds made it (reflux, gerd, belching all of it) worse, (everytime)... so they put me on acid blockers, I was eating tums, and gas X daily... it still got worse; then a coating grew on my tongue...doc says they dont know what causes that exactly, for years they told me this, and I had to figure it out on my own!... ;

     

    It was the prescription acid blockers; After 12 years of being misdiagnosed with every syndrome under the sun; I was suffering from chronic malabsorbtion... this over stimulated or under-stimulated all of my endocrine glands, thyroid slowed down; had nodules all over it; I got fat and sick, and in even more excruciating joint (bone) pain (yea, they called that arthritis at 34!)... the parathyroid kept pumping out PTH like no tomorrow, (and they never checked that until I INSISTED ON IT) which pulled calcium right out of my bones...causing a parathyroid adenoma.

     

    By this time, the high PTH made my calcium way too high (10.2-10.8) plenty high for me; and my Vitamin D hit the floor at only 7-11! this also caused my BP to be high near the end, but it was low for years and I was not an athelete;, as well as high cholesterol; the good cholesterol was really good, the bad was really bad...

     

    I was belching 24-7, even laying in the bed in the morning upon waking, belch belch belch, all the way to the coffee pot; ... my stomach felt so bloated like I was 9 mos. prego all the time.

     

    I had the parathyroid ademoma removed with the minimally invasive radioguided technique; (don't get any other kind in my opinion MIRP or bust!) this immediately stopped the bone pain from leaching calcium; this also stopped the belching for the most part, but not completely..

     

    None of it was completely cured until I figured out that it was not only gluten I had intolerence to...it is also some forms of fructose..the double sugars in particular, like garlic, onions, mushrooms, cabbage family veggies; apples, pears, raisins, honey, etc.

     

    I am now following a LOW FODMAP food list and it is working wonderfully, when I remember to read ALL labels to ensure, no honey, no sugar free ingredients, no Xanthan gum, or any gluten dirivitive...and there are so many.

     

    FODMAP is an acronym for different food groups and how they break down into sugars. Seems I lack a certain enzyme to break down "double sugar" foods, like wheat and corn gluten; while regular sugar is fine...but the doubles will start the belching, bloating, arms and legs going numb, insomnia, and just feel puffy, tired, achy and depressed!

     

    For me, Its all about the VILLI..if damaged from food intolerences, you cant uptake nutrients from food, and digestiion does not work right at all... and you cant process what you have eaten; there is NO PILL TO FIX ANY OF THIS: diet changes are KEY; Good article, yes, its definitely related to food intolerance!! Read Dr. James Norman's new study on GERD and the parathryoid, (I participated in this one, may not be published yet)..

     

    I have gone a step further and linked the reason my (2 out of 4) parathyroids were bad...its all about the villi, chronic malabsorbtion will ruin your endrocrine system after years of eating all the wrong things (and pills make it even worse because they have cellulose and gluten fillers!! - MIRP surgery 4-27-11; only the bone pain and most (not all) of the belching/acid cured; went gluten free in July 2011; symptoms changed as my diet did, still had IBS but it was now different, and definatly related to fruits, as I was now aware of everything I was eating by going gluten free;

     

    I went low fodmap in September... this is heaven now, I am me again, what a journey! I feel light, never bloated, mind feels sharp, memory has improved greatly, along with energy, outlook, good sleep, and a bonus of a negative 40lbs! oh, yea,.....and no more IBS or migranes or high blood pressure, or high cholesterol, and I eat very well, anything I can dream up, as long as the ingredients are low in double sugars!!

     

    This was the easiest trade off in my life compaired to the hell the doctors and surgeons put me though! FOOD< who knew? Veneers for my teeth are the next step and the last to truly feel like myself again! I now feel like I did in high school, never thought it possible.

     

    Thank you all at Celiac.com... all the articles here are wonderful, such a life saver!

    Lori,

    You are my kindred spirit. I went through all those diagnoses as well. It's quite frustrating, since I my records carry the words "mental illness", depression, etc., due to their misdiagnosis. I wonder how much better my life would have been, if only they had found the gluten intolerance and 20+ food allergies a long time ago. My health has severely suffered due to 20+ years of vitamin malabsorption.

    Thank you for sharing!

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    Bardella MT, Minoli G, Ravizza D, et al Arch Intern Med. 2000 May 22;160(10):1489-91
    (Celiac.com 07/09/2000) Approximately 30% to 40% of patients with celiac disease (which affects at least 1 in 200 individuals) also have symptoms of dyspepsia. There is, however, a lack of data regarding the prevalence of celiac disease in patients with dyspepsia.
    Methods: All outpatients who underwent an endoscopy of the upper gastrointestinal tract for dyspepsia were enrolled at our center between January and June 1998. All patients under 12 years old were excluded, as were all patients who had been diagnosed with other gastrointestinal diseases, were suspected to have celiac disease, or had malabsorption, and/or iron-deficiency anemia.
    Results: 517 (17%) out of 3,019 patients (age range, 20-46 years) were eligible for the study. Endoscopic findings suggested celiac disease in 5 cases, and was histologically diagnosed in 6 of the patients (5 women and 1 man; mean age, 31.3 years). Of the six, 3 had a normal endoscopic pattern, and 3 had a pattern that was consistent with celiac disease. Follow up antiendomysium antibody positivity supported the diagnosis in the patients with histologically diagnosed celiac disease. The relative risk for celiac disease was 2.32 (95% confidence interval, 1.06-5.07) in comparison with the general population, and it was higher among females (3.22; 95% confidence interval, 1.37-7.56).
    Conclusions: The prevalence of celiac disease in patents with dyspepsia is twice that of the general population. As a result, serological screening for celiac disease should be considered in the early workup of these patients to allow diagnosis and treatment of what is a treatable disease.

    Jefferson Adams
    Celiac.com 11/21/2008 - Not much is known about what effects, if any, a gluten-free diet might have upon gastroesophageal reflux disease-related symptoms (GERD-rs) in people with celiac disease. A team of researchers recently set out to assess the recurrence of GERD-rs, in celiac patients with nonerosive reflux disease (NERD).
    Out of a total of 105 adult patients with celiac disease, the team found 29 with celiac disease who presented with the NERD. Those 29 were enrolled in the study, and compared against a control group of thirty non-celiac patients with NERD.
    After 8 weeks of PPI treatment the team found that 25 (86.2%) celiac patients saw GERD-rs resolve, compared to just 20 (66.7%) control subjects. The team used clinical means to assess recurrence of GERD-rs at 6, 12, 18, and 24-month intervals after initial proton-pump inhibitor (PPI) treatment were withdrawn for 8 weeks.
    In the celiac disease group, just five patients (20%) had a recurrence of GERD-rs at 6 months, but none had recurrence at 12, 18, and 24 months, while the control group showed recurrence in six of 20 controls (30%) at 6 months, in another six (12/20, 60%) at 12 months, in another three (15/20, 75%) at 18 months, and in another two (17/20, 85%) at 24 months.
    This is the first study to evaluate the effect of a gluten free diet in the nonerosive form of GERD in patients with celiac disease, via a clinical long-term follow-up, and the results suggest that a gluten free diet could be helpful reducing GERD symptoms and in preventing of their recurrence.
    J Gastroenterol Hepatol.  2008;23(9):1368-1372.


    Jefferson Adams
    Celiac.com 06/28/2013 - Celiac disease has been linked to gastroesophageal reflux disease (GORD) and eosinophilic esophagitis (EoE), but there is very little data from population-based studies on the rates of shared disease among these groups. To get a better picture of the issue, a team of researchers recently set out to conduct a population-based study on rates of celiac disease in people with gastroesophageal reflux disease (GORD) and eosinophilic esophagitis (EoE).
    The research team included Jonas F. Ludvigsson, Pertti Aro, Marjorie M. Walker, Michael Vieth, Lars Agréus, Nicholas J. Talley, Joseph A. Murray, and Jukka Ronkainen. They are variously affiliated with the Department of Medicine at Karolinska University Hospital and Karolinska Institutet, Clinical Epidemiology Unit, in Stockholm, Sweden, the Department of Pediatrics at Örebro University Hospital in Örebro, Sweden, the Departments of Medicine and Immunology in the Division of Gastroenterology and Hepatology at the Mayo Clinic College of Medicine in Rochester, USA, the Department of NVS, Center for Family and Community Medicine, Karolinska Institutet, Stockholm, Sweden, the Faculty of Health at the University of Newcastle in Newcastle, Australia, the Institute of Pathology in Bayreuth, Germany, the Primary Health Care Center of Tornio, Finland, and the Institute of Health Sciences at the University of Oulu in Oulu, Finland.
    For their study, the team conducted endoscopes on a thousand randomly selected adults from the general population.
    They defined celiac disease as positive serology together with mucosal abnormalities of the small intestine. They defined any eosinophil infiltration of the esophageal epithelium as esophageal eosinophilia and EoE was defined as having at least 15 eosinophils/high-power field in biopsies from the distal esophagus.
    They used Fisher's exact test to compare the prevalence of GORD, esophageal eosinophilia, and EoE in subjects with celiac disease, and to compare the realists with those of the control group.
    Of the 400 subjects (40%) with gastroesophageal reflux symptoms (GORS), 155 (15.5%) had erosive esophagitis, 16 (1.6%) had Barrett's esophagus, 48 (4.8%) had esophageal eosinophilia, and 11 (1.1%) had EoE.
    They diagnosed celiac disease in eight (2%) of the 400 individuals with GORS, compared to 10 of 600, or 1.7% for the control group (p = 0.81). They also diagnosed celiac disease in 3 of 155 subjects (1.9%) with erosive esophagitis, compared with 15 of 845 (1.7%) of control subjects (p = 0.75); and 2 cases of celiac disease from the 48 (4.2%) individuals with esophageal eosinophilia (controls were 16 of 952 (1.7%), p = 0.21).
    They found no celiac disease, however, in any of the 16 subjects with Barrett's esophagus, while they did find 18 cases among the 984, or 1.8% of control subjects; p = 1.0.
    Nor did they find celiac disease in any of the 11 individuals with EoE, compared with 18 cases in the 989, or 1.8% of control subjects; p = 1.0.
    Because this population-based showed no increased risk of celiac disease among individuals with GORD, esophageal eosinophilia, or EoE, they conclude that there is no need to conduct celiac screening of individuals with GORD, or EoE screening of individuals with celiac disease.
    Source:
    Informa Healthcare. doi:10.3109/00365521.2013.792389

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    J Clin Gastroenterol. 2018 Mar 1. doi: 10.1097/MCG.0000000000001018.

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    Celiac.com 04/21/2018 - Dear Friends and Readers,
    I have been writing articles for Scott Adams since the 2002 Summer Issue of the Scott-Free Press. The Scott-Free Press evolved into the Journal of Gluten Sensitivity. I felt honored when Scott asked me ten years ago to contribute to his quarterly journal and it's been a privilege to write articles for his publication ever since.
    Due to personal health reasons and restrictions, I find that I need to retire. My husband and I can no longer travel the country speaking at conferences and to support groups (which we dearly loved to do) nor can I commit to writing more books, articles, or menus. Consequently, I will no longer be contributing articles to the Journal of Gluten Sensitivity. 
    My following books will still be available at Amazon.com:
    Gluten-free Cooking for Dummies Student's Vegetarian Cookbook for Dummies Wheat-free Gluten-free Dessert Cookbook Wheat-free Gluten-free Reduced Calorie Cookbook Wheat-free Gluten-free Cookbook for Kids and Busy Adults (revised version) My first book was published in 1996. My journey since then has been incredible. I have met so many in the celiac community and I feel blessed to be able to call you friends. Many of you have told me that I helped to change your life – let me assure you that your kind words, your phone calls, your thoughtful notes, and your feedback throughout the years have had a vital impact on my life, too. Thank you for all of your support through these years.

    Jefferson Adams
    Celiac.com 04/20/2018 - A digital media company and a label data company are teaming up to help major manufacturers target, reach and convert their desired shoppers based on dietary needs, such as gluten-free diet. The deal could bring synergy in emerging markets such as the gluten-free and allergen-free markets, which represent major growth sectors in the global food industry. 
    Under the deal, personalized digital media company Catalina will be joining forces with Label Insight. Catalina uses consumer purchases data to target shoppers on a personal base, while Label Insight works with major companies like Kellogg, Betty Crocker, and Pepsi to provide insight on food label data to government, retailers, manufacturers and app developers.
    "Brands with very specific product benefits, gluten-free for example, require precise targeting to efficiently reach and convert their desired shoppers,” says Todd Morris, President of Catalina's Go-to-Market organization, adding that “Catalina offers the only purchase-based targeting solution with this capability.” 
    Label Insight’s clients include food and beverage giants such as Unilever, Ben & Jerry's, Lipton and Hellman’s. Label Insight technology has helped the Food and Drug Administration (FDA) build the sector’s very first scientifically accurate database of food ingredients, health attributes and claims.
    Morris says the joint partnership will allow Catalina to “enhance our dataset and further increase our ability to target shoppers who are currently buying - or have shown intent to buy - in these emerging categories,” including gluten-free, allergen-free, and other free-from foods.
    The deal will likely make for easier, more precise targeting of goods to consumers, and thus provide benefits for manufacturers and retailers looking to better serve their retail food customers, especially in specialty areas like gluten-free and allergen-free foods.
    Source:
    fdfworld.com

    Jefferson Adams
    Celiac.com 04/19/2018 - Previous genome and linkage studies indicate the existence of a new disease triggering mechanism that involves amino acid metabolism and nutrient sensing signaling pathways. In an effort to determine if amino acids might play a role in the development of celiac disease, a team of researchers recently set out to investigate if plasma amino acid levels differed among children with celiac disease compared with a control group.
     
    The research team included Åsa Torinsson Naluai, Ladan Saadat Vafa, Audur H. Gudjonsdottir, Henrik Arnell, Lars Browaldh, and Daniel Agardh. They are variously affiliated with the Institute of Biomedicine, Department of Microbiology & Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Karolinska University Hospital and Division of Pediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden; the Department of Clinical Science and Education, Karolinska Institute, Sodersjukhuset, Stockholm, Sweden; the Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden; the Diabetes & Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; and with the Nathan S Kline Institute in the U.S.A.
    First, the team used liquid chromatography-tandem mass spectrometry (LC/MS) to analyze amino acid levels in fasting plasma samples from 141 children with celiac disease and 129 non-celiac disease controls. They then crafted a general linear model using age and experimental effects as covariates to compare amino acid levels between children with celiac disease and non-celiac control subjects.
    Compared with the control group, seven out of twenty-three children with celiac disease showed elevated levels of the the following amino acids: tryptophan; taurine; glutamic acid; proline; ornithine; alanine; and methionine.
    The significance of the individual amino acids do not survive multiple correction, however, multivariate analyses of the amino acid profile showed significantly altered amino acid levels in children with celiac disease overall and after correction for age, sex and experimental effects.
    This study shows that amino acids can influence inflammation and may play a role in the development of celiac disease.
    Source:
    PLoS One. 2018; 13(3): e0193764. doi: & 10.1371/journal.pone.0193764