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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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    CELIAC DISEASE PATIENTS HAVE HIGHER RATES OF IRRITABLE BOWEL-LIKE SYMPTOMS


    Jefferson Adams

    Celiac.com 02/25/2013 - Patients with celiac disease often report symptoms compatible with irritable bowel syndrome (IBS). However, there haven't been any systematic studies regarding how adherence to a gluten-free diet might affect rates of irritable bowel syndrome-type symptoms in patients with celiac disease.


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    Photo: CC--mag3737To better answer that question, a research team conducted a meta-analysis of celiac disease patients to determine rates of irritable bowel syndrome-type symptoms, and how those symptoms relate to a gluten-free diet.

    The research team included A. Sainsbury, D.S. Sanders, and A.C. Ford, of the Leeds Gastroenterology Institute at St James's University Hospital in Leeds, United Kingdom.

    For their analysis, the team searched MEDLINE, EMBASE, and EMBASE Classic to identify cross-sectional surveys or case-control studies reporting prevalence of IBS-type symptoms in adult patients (≥16 years old) with established celiac disease.

    The team used case or control status and adherence to a gluten-free diet to determine the number of individuals with IBS symptoms.

    The team analyzed data from 7 studies with 3383 participants.
    They then calculated pooled prevalence and odds ratios (ORs), with 95% confidence intervals (CIs).

    They found that pooled prevalence of IBS-type symptoms in all patients with celiac disease was 38.0% (95% CI, 27.0%-50.0%).

    People with celiac disease had higher pooled odds ratios for IBS-type symptoms than did control subjects (5.60; 95% CI, 3.23-9.70).

    In patients who did not follow a strict gluten-free diet, the pooled odds ratios for IBS-type symptoms, compared with those who were strictly adherent, was 2.69 (95% CI, 0.75-9.56).

    Patients who did not adhere to the gluten-free diet had higher odds ratios for IBS-type symptoms compared with controls (12.42; 95% CI, 6.84-11.75).

    Such patients also had higher odds ratios compared with that observed for celiac disease patients who followed a strict gluten-free diet or controls (4.28; 95% CI, 1.56-11.75).

    The results show that patients with celiac disease suffer IBS-type symptoms more frequently than control subjects, and that following a strict gluten-free diet might help to reduce those symptoms.

    Source:


    Image Caption: Photo: CC--mag3737
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    Guest dappy

    Posted

    Before diagnosis, I was told I had IBS. I was afraid to leave the house due to uncontrolled diarrhea. However, even after having celiac disease confirmed first with blood work and then with a genetics test, and going completely gluten-free, it persisted. Only after finally starting a probiotic, Align, did it finally get back under control.

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    Guest Ann Mitchell

    Posted

    I am gluten-sensitive and have bad constipation. Taking digestive enzymes to cure this, hopefully. At the moment, have to do laxatives to make me "go".

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    Guest Susan

    Posted

    I was diagnosed with IBS years ago and had to take Bentyl to stop the attacks. NO ONE suggested that I might be gluten intolerant.

     

    On my own research, I learned about gluten intolerance. I decided to go gluten-free for 3 weeks to see if I had any positive results. Here were my results:

     

    IBS disappeared

    Arthritis pain lessened

    Some relief of fatigue, tho, with thyroid disease and lupus and fibromyalgia, there is a long way to go.

     

    After going back on gluten products for only 3 days, arthritis pain increased to full-blown

    IBS symptoms returned, back to Bentyl

     

    Gluten intolerance is REAL. A gluten-free diet eliminated IBS completely... though, now I sometimes have constipation... which is easier to deal with and less painful.

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    admin

    Lancet Nov 2001 Volume 358, Number 9292 1504-08 03
    Celiac.com 11/14/2001 - A recent study published in The Lancet by Dr. David S Sanders et al. of the Gastroenterology and Liver Unit, Royal Hallamshire Hospital, Sheffield, UK, explored the number of people who were diagnosed with irritable bowel syndrome but actually had celiac disease.
    The case-control study was done at a university hospital in which 300 consecutive new irritable bowel syndrome patients who met the Rome II criteria for their diagnosis were compared against 300 healthy age and sex-matched controls. Both groups were investigated for celiac disease by analysis of their serum IgA antigliadin, IgG antigliadin, and endomysial antibodies (EMA). Patients and controls with positive antibody results were offered duodenal biopsy to confirm the possibility of celiac disease.
    An amazing 66 patients with irritable bowel syndrome tested positive for the antibodies, and 14 of them or 4.6% had active celiac disease as compared with 2 or 0.66% of the non-IBS matched controls. In other words there is a sevenfold increase over the normal population in the number of people with IBS who have celiac disease. All of the patients with celiac disease in the IBS group were therefore misdiagnosed. The study did not indicate how many of the other 52 patients who had positive antibody results would eventually develop celiac disease, but this would be an interesting follow-up study. Celiac.com believes that the 4.6% with celiac disease will grow higher over time.
    Conclusion: All patients with irritable bowel syndrome should be screened celiac disease.

    admin
    Aliment Pharmacol Ther 19(11):1199-1210, 2004.
    Celiac.com 06/08/2004 - Researchers at the University of California, San Francisco have determined that everyone with Irritable Bowel Syndrome (IBS) should also be screened for celiac disease. The researchers used decision analysis to estimate the number of celiac disease cases detected, quality-adjusted life-years gained, and costs resulting from screening suspected IBS patients for tissue transglutaminase antibody and antibody panel. Positive tests were followed up with an endoscopic biopsy. A gluten-free diet was initiated to improve the quality of life in those with celiac disease.
    The results of this study indicate that 3% of the 1,000 patients with suspected IBS have celiac disease. Based on these results the researchers analyzed the costs of several celiac disease screening methods used a decision analysis formula to determine whether or not the screening is cost effective. The researchers conclude that celiac disease screening in patients with suspected irritable bowel syndrome is likely to be cost-effective even at a relatively low celiac disease prevalence.
    Perhaps the researchers should have taken their analysis one step further and concluded that it would make good economic sense to screen the entire population of the USA (as well as that of other countries) for celiac disease, rather than just those with IBS, given the fact that it affects approximately 1% of the population--which is the only conclusion that I could reach after my review of their good work. -Scott Adams

    Jefferson Adams
    Celiac.com 05/06/2008 - In the majority of people with celiac disease,strict adherence to a gluten-free diet can result in a quality of lifethat is on par with non-celiacs. Still a small percentage of celiacsseem to suffer from persistent gastrological discomfort in the form ofirritable bowel or irritable-bowel-like symptoms. Very few studies havebeen done on persistent gastrological problems in adults with celiacdisease. Those that have been done rely upon univariate statisticalanalysis in clinical samples at the secondary or tertiary care leveland fail to assess the potential influence of non-celiac diseasespecific factors, which are considered to be a risk factor of irritablebowel syndrome (IBS), such as mental disorders, or gender.
    Ateam of researchers made up of doctors Winfried Hauser, Frauke Musial,Wolfgang Caspary, Jurgen Stein, and Andreas Stallmach set out todetermine rates of irritable bowel syndrome, irritable bowelsyndrome-related symptoms, and consecutive health care-seeking behaviorand their influence upon health-related quality of life (HRQL) and anyconceivable bio-psychosocial factors influencing adult patients withceliac disease. The research team made a medical and socio-demographicsurvey of 1000 adult celiac patients from the German Celiac Society bypost. The medical portion of the survey included bowel history. Theteam also had patients fill out a Short Form Health Survey (SFHS),along with the Hospital Anxiety and Depression Scale.
    516 ofthe questionnaires came back completed. Respondents were similar ingender ratio and median age from the whole membership directory of theGerman Celiac Society, a group of more than 18,000 people who reportedsuffering from celiac disease at the age of 18. Of these, 213 (41.3%)had a diagnosis of celiac disease that was made by a duodenal biopsy,37 (7.2%) by serological tests (celiac disease-specific antibodies), 34(6.6%) using stool tests for trans-glutaminase antibodies, and 232(45.0%) using intestinal biopsy and serological tests.
    A totalof 446 patients indicated that they had biopsy-proven celiac disease. Of these 446patients, 18 were excluded because they indicated adherence to agluten-free diet for less than 1 year. Sixteen patients were tossed outbecause they reported a major non-adherence to the gluten-free diet. Thus,the study group was confined to 412 patients with self-reportedbiopsy-proven celiac disease who were on a strict gluten-free diet for at least one year. The survey showed that out of these 412 patients that met the criteria, 96 patients, or just over 23% metmodified Rome I criteria for Irritable Bowel Syndrome. Of those 96patients, 76 patients, or nearly 80%, made an effort to get help, bothmedical and non-medical, as a result of the bowel symptoms (we’ll callthe patients who sought help "irritable bowel syndrome patients").
    Irritable bowel syndrome-like symptoms were shown to drive SFHS scores sharply downward. Mentalhealth disorders, being female, falling off the gluten-free dietall contributed to a greater likelihood of irritable bowel syndrome symptoms.
    Theresults of the study seem strengthen the bio-psychosocial model of irritable bowel syndrome, in which biological and psychological factorsare understood to affect the clinical manifestation of celiac disease.Under this model, irritable bowel syndrome-like symptoms in adults withceliac disease are understood through a combination of clinical andsocio-psychological mechanisms. This model leads doctors to anunderstanding of celiac disease and other gastro-intestinal ailmentsthat goes beyond simple biological or psychological factors alone, andlooks at factors like adverse life events, stress, and hypochondriasisamong others.
    Limited studies indicate that gender differencesin visceral perception, cardio-autonomic responses, gastrointestinalmotility, and brain activation patterns to visceral stimuli are afactor in irritable bowel syndrome. Gender differences in psychosocialfactors have not been fully studied.
    The results of this studyalso support the need for further investigation to determine exactly whatfactors contribute to the bio-psychosocial model of what is called’celiac irritable bowel syndrome.’
    Future psycho-physiologicalstudies in patients with celiac disease and irritable bowel syndromeshould look to determine if psychological discomfort can prolongmucosal inflammation, reduce visceral pain thresholds, or disturb gutmotility.
    In the event that the right psychotherapeutictreatment for irritable bowel syndrome-like symptoms and/or mentaldisorder serve to improve reduced HRQOL in adult patients with celiacdisease and irritable bowel syndrome-like symptoms, it might benecessary to take a second look at interventional practices.
    So,in a nutshell, this all means that things like mental health, gender,and other non-clinical factors might play a role in irritable bowelsyndrome-like symptoms in people with celiac disease, and that furtherstudy is needed to sort out all of the possibilities and determine ifthere might be better ways to treat celiac disease that will reduce oreliminate irritable bowel syndrome-like symptoms.
    Psychosomatic Medicine 69:370 –376 (2007)


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    Celiac.com 04/26/2018 - Emily Dickson is one of Canada’s top athletes. As a world-class competitor in the biathlon, the event that combines cross-country skiing with shooting marksmanship, Emily Dickson was familiar with a demanding routine of training and competition. After discovering she had celiac disease, Dickson is using her diagnosis and gluten-free diet a fuel to help her get her mojo back.
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    Jefferson Adams
    Celiac.com 04/23/2018 - A team of researchers recently set out to learn whether celiac disease patients commonly suffer cognitive impairment at the time they are diagnosed, and to compare their cognitive performance with non-celiac subjects with similar chronic symptoms and to a group of healthy control subjects.
    The research team included G Longarini, P Richly, MP Temprano, AF Costa, H Vázquez, ML Moreno, S Niveloni, P López, E Smecuol, R Mazure, A González, E Mauriño, and JC Bai. They are variously associated with the Small Bowel Section, Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital; Neurocience Cognitive and Traslational Institute (INECO), Favaloro Fundation, CONICET, Buenos Aires; the Brain Health Center (CESAL), Quilmes, Argentina; the Research Council, MSAL, CABA; and with the Research Institute, School of Medicine, Universidad del Salvador.
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    Source:
    J Clin Gastroenterol. 2018 Mar 1. doi: 10.1097/MCG.0000000000001018.

    Connie Sarros
    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. 
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