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    Celiac Disease Screening


    Scott Adams


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    Celiac.com 02/08/2007 - For anyone with a family history of celiac disease or of disorders such as thyroid disease, anemia of unknown cause, type I diabetes or other immune disorders or Downs syndrome, doctors may suggest routine screening. Otherwise, patients are generally screened on a case by case basis according to individual symptoms.

    People with celiac disease have abnormally high levels of associated antibodies, including one or more of the following: anti-gliadin, anti-endomysium and anti-tissue transglutaminase, and damage to the villi (shortening and villous flattening) in the lamina propria and crypt regions of their intestines when they eat specific food-grain antigens (toxic amino acid sequences) that are found in wheat, rye, and barley.

    Antibodies are the specialized proteins the immune system uses to break down and eliminate foreign substances from the body. In people with celiac disease, the immune system treats gluten as a foreign invader and produces elevated levels of antibodies to get rid of it, causing symptoms and associated discomfort.

    Testing & Diagnosis

    A blood test, such as anti-tissue transglutaminase and anti-endomysial antibodies, can detect abnormally high antibody levels, and is often used in the initial detection of celiac in people who are most likely to have the disease, and for those who may need further testing.

    Since the immune system of a person with celiac treats gluten as a foreign substance and increases the number of antibodies, elevated levels of these antibodies are a sign of celiac disease.

    To confirm the diagnosis, your doctor may need to do a biopsy, that is, microscopically examine a small portion of intestinal tissue to check for celiac associated damage to the small intestine. To do this, your doctor inserts a thin, flexible tube (endoscope) through your mouth, esophagus and stomach into your small intestine and takes a sample of intestinal tissue to look for damage to the villi (tiny, hair-like projections in the walls the small intestine that absorb vitamins, minerals and other nutrients).

     


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    This site is extremely informative and helpful for a newcomer. Thanks.

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    Guest Lucinda Crim

    Posted

    I was diagnosed with Multiple Sclerosis in 1993 and I'm a R.N. who became disabled unable to continue working and I was put on SSDI. I got divorced and then re-married in 2001. My step-son HAS AUTISM and my husband is diagnosed with ADD. So I read Dr. Shari Lieberman's book and I decided to start my family on a Diary Free and a GLUTEN-Free Diet. I was a Dietian Major before. I was a Nursing Major in College. So I have had this interest in diets and how they affects us. So we have taken out dairy products already. So just need to add Gluten to things to remove from our diet. Ive removed sugar and chocolate already because of it's affect it had on me. Thank You for your time. I'm always open for suggestions.

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    Guest Karen Adam

    Posted

    I believe the serum test and the biopsy to give many false negatives. There is a new test designed by Dr. Harry Delcher in Atlanta GA that is quite accurate. I believe it to measure antibodies in a stool sample.

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    Guest Karen Schmidt

    Posted

    I was just diagnosed via a stool sample. I was told that blood tests can result in false negatives, where the stool test isn't accurate.

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    Guest Lorraine

    Posted

    Information is very helpful and informative.

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    Guest Kim Grant

    Posted

    Did you say the stool test is or isn't accurate. We just ordered the test kit for $394 for Enterolabs and would like to know if this is a valid method of testing.

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    Guest Sensitive Bud

    Posted

    Did you say the stool test is or isn't accurate. We just ordered the test kit for $394 for Enterolabs and would like to know if this is a valid method of testing.

    Enterolab is excellent & a valid method. As stated above " A blood test, such as anti-tissue transglutaminase and anti-endomysial antibodies, can detect abnormally high antibody levels, and is often used in the initial detection of celiac." Unfortunately, blood test may miss up to 70% of gluten sensitivities & an invasive biopsy is almost always uncalled for because DNA gene testing can confirm results. If one has the Celiac sprue gene or 1 or 2 gluten sensitivity genes from their parents & are experiencing an autoimmune response to their sensitivity they most likely have damage in the small intestine. A Biopsy only tells on how much damage; why bother with an invasive procedure when it is not needed! You need to stop the damage ASAP & go gluten free.

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    Guest Sandra

    Posted

    Enterolab is excellent & a valid method. As stated above " A blood test, such as anti-tissue transglutaminase and anti-endomysial antibodies, can detect abnormally high antibody levels, and is often used in the initial detection of celiac." Unfortunately, blood test may miss up to 70% of gluten sensitivities & an invasive biopsy is almost always uncalled for because DNA gene testing can confirm results. If one has the Celiac sprue gene or 1 or 2 gluten sensitivity genes from their parents & are experiencing an autoimmune response to their sensitivity they most likely have damage in the small intestine. A Biopsy only tells on how much damage; why bother with an invasive procedure when it is not needed! You need to stop the damage ASAP & go gluten free.

    My daughter had the blood test and tested negative. She did have a gene for celiac sprue and one for gluten sensitivity on DNA testing. On stool testing, she was found sensitive to wheat. She then had a food panel done, but had been on a gluten free diet for two months and again tested negative for a wheat allergy. I am getting confused on what constitutes a "good" test for this condition.

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    Guest Cinderfin

    Posted

    My daughter had the blood test and tested negative. She did have a gene for celiac sprue and one for gluten sensitivity on DNA testing. On stool testing, she was found sensitive to wheat. She then had a food panel done, but had been on a gluten free diet for two months and again tested negative for a wheat allergy. I am getting confused on what constitutes a "good" test for this condition.

    I was told from my doctor that you can't be practicing a gluten-free diet before your tests prognosis because it will decrease the levels of your natural antibodies.

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    Guest Robin Neudorfer

    Posted

    This is still a confusing subject, because the anecdotal evidence is not in line with the "research".

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    Guest Beverly Buxton

    Posted

    I 'm looking this information up for a DEAR friend of mine,she is fadding away & I AM VERY concerned about her.

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    Guest wheat intolerance

    Posted

    This is a good post. Thanks for sharing.

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    This is a good post. Thanks for sharing.

    Can you request a Stool Analysis from your doctor? I just was tested (blood test) and my result was 14. They told me 0-19 was the normal range. But a 14 means there were some antibodies towards gluten...

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    Guest Christina

    Posted

    My daughter has had symptoms for almost a year now. Been to the daughter many times, all kinds of tests, and nothing. After reading allot from this site I think I will start with the blood test and if needed the stool sample. Thanks everyone for sharing.

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    Guest Jillian

    Posted

    I was told from my doctor that you can't be practicing a gluten-free diet before your tests prognosis because it will decrease the levels of your natural antibodies.

    This is true. In order to produce antibodies against a substance (or have high enough antibodies circulating to result in a positive test) the antigen must be present. In the case of celiac disease, the antigen is gluten. DO NOT go on a gluten-free diet prior to testing.

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    Mt daughter just had a scope done and she had a lot of lymphoid nodules and was just curious if this also was a sign of celiac? They took biopsy's of it but I just wondered if other people had this problem when they had a scope done!

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    I have celiac disease and I want to get my children screened. Does anyone know how they do this my daughter is 3 1/2 and I have a sneaky suspicion that she may have it as well.

     

    Is it just a blood test or do they do a biopsy as well?

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    Enterolab is excellent & a valid method. As stated above " A blood test, such as anti-tissue transglutaminase and anti-endomysial antibodies, can detect abnormally high antibody levels, and is often used in the initial detection of celiac." Unfortunately, blood test may miss up to 70% of gluten sensitivities & an invasive biopsy is almost always uncalled for because DNA gene testing can confirm results. If one has the Celiac sprue gene or 1 or 2 gluten sensitivity genes from their parents & are experiencing an autoimmune response to their sensitivity they most likely have damage in the small intestine. A Biopsy only tells on how much damage; why bother with an invasive procedure when it is not needed! You need to stop the damage ASAP & go gluten free.

    How are we to be tested? Everyone is saying don't go gluten free before testing? what the heck should I do?

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    What do I do? Go gluten free now? Before I have tests done, which test do I have the doctor do? I don't want to end up in the ER with abdominal pain again.

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    What do I do? Go gluten free now? Before I have tests done, which test do I have the doctor do? I don't want to end up in the ER with abdominal pain again.

    Don't change your diet before. I suggest an Adrenal Stress Test (I got @ my doc office but you can get online). I'm diabetic & had weight gain, swelling, high blood sugar, nausea, tireness, & trouble sleeping. When thyroid tests came back ok my doc request ADT. It only cost $120. Found out I had Insulin Resistance (causing high bloodsugar), high cortisol at night (trouble sleeping), & gluten intollerance (all other symptoms). The AST is done at home over a 24hour period, you have 4 small viles of cottom, each marked with the time of day to take the sample. I placed the cotton under my toung to fully saturate it with saliva, placed it back in the vile, wrote the time on it & put it in the fridge until the last of the samples are completed. Then I put them all in the box provided with my payment & dropped it off at the post office. About 2-3 weeks later I saw my doc for the amazing results.

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    Guest Debbie

    Posted

    Information I've been looking for. And my daughter had this website 2 years ago. It was nice to be able to give her the site she lost and a website I and my husband will use.

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    Guest butterfly

    Posted

    Information I've been looking for. And my daughter had this website 2 years ago. It was nice to be able to give her the site she lost and a website I and my husband will use.

    This is a fantastic resource. Thank you everyone for offering your experiences however...I remain confused. What about those people who are forced to eliminate those key foods from their diet prior to having blood tests drawn in order to survive? The love of my life is wasting away; 207# down to 139#. Is anyone on or considering TPN? Please help.

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    Guest Teresa

    Posted

    This is a fantastic resource. Thank you everyone for offering your experiences however...I remain confused. What about those people who are forced to eliminate those key foods from their diet prior to having blood tests drawn in order to survive? The love of my life is wasting away; 207# down to 139#. Is anyone on or considering TPN? Please help.

    Butterfly,

    I hope you find this answer helpful even though I'm not to the point of considering TPN. Is she vomiting a lot? I ask because I was only diagnosed with celiac disease 3 days ago after a week long hospital stay in which I kept a total of 3 meals down. But I have been suffering from the vomiting, diarrhea, debilitating abd and back pain and other related symptoms for years with the doctors telling me it was a virus, that I had severe IBS and a lot of other crap that I'm beginning to believe is common to people suffering with this disease and you come to the point that the frustration that no one will really help you, the depression that this is, apparently, your life from now on and the way you can see that frustration and depression affecting your family and you just become consumed by the frustration and depression and nothing really matters but making the pain and the vomiting stop.

     

    Was she been diagnosed recently? I ask because I was thrilled to be diagnosed, sure that a few IV's and follow up pills would cure me or at least give me enough relief that I could return to my former life. I was once again in charge of my own life, that I, with enough research, planning and sheer strength of will could kick this diseases' butt. But my bubble was certainly popped when the dietician arrived to explain the disease to me in a way the doctor hadn't bothered to (the big coward). I felt that control slipping a little but my determation didn't waver. So, I got on the internet and the remainder of that control was not taken away so much as buried under the bombardment of conflicting information that left me reeling in confusion.

     

    And that wasn't even the worst part. The worst part was that most of my beloved foods (hot yeast rolls smeared with honey butter, bread pudding with caramel whiskey sauce, birthday cake with whipped icing, ok going to stop now because typing this is just making me angry and very, very hungry:) My point is that knowing you have to change the eating habits of a lifetime (and yeah, I know the above aren't really healthy choices but they are definitely yummy;) and knowing that these changes have to be permanent, that your very life may depend on it is sort of overwhelmingly terrifying. And having too many things that you absolutely love in your diet taken away is pretty darn depressing, especially when the people taking it away smile, practically pat you on the head and tell you that you will be MUCH BETTER OFF, health wise with this diet than your own eating habits.

     

    Right now, I'm just so completely overwhelmed with the conflicting opinions (medical and otherwise) that I'm almost afraid to eat anything. I mean a product that has wheat, barley or rye in it can get around the labeling law by simply listing this as malt flavoring and you just don't know if it is safe or not without contacting the manufacturer of that product. Seriously? Knowing that I would have to be reading labels for the rest of my life didn't exactly fill me with joy but knowing those labels might be misleading and I will have to be, basically, researching my food before it can pass my lips kind of makes me want to pull my hair out in frustration but, hey, maybe that's just me:)

     

    So far I've used my admittedly fledgeling experience to let you know how the process of being diagnosed has affected me and, I'm guessing, to a degree, a large portion of celiac patients. Now, I'm going to give you some advice as an RN with 20+ years of experience. A weight of 68 pounds is significant, especially if she is eating much at all. I don't know what time frame this weight loss occurred so I couldn't hazard a guess as to whether it is completely Celiac related or if depression is playing a part in it. What I can tell you with utter certainty is that this is a trend you should be concerned about and if your doctor has discussed TPN with you then he, too, considers it a problem. I guess, it all boils down to do you trust your doctor or not? If you do, then know, that this is a recommendation I wouldn't expect him to make lightly if he saw an alternative. If you don't trust him then I can see you doubting the validity of TPN and I would strongly recommend that you find one you can trust because this is a lifelong illness and the more people you have in your corner the easier it will be.

     

    I know this was a rather long winded reply but I hope it makes you smile even if it isn't all that helpful.

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    Jefferson Adams
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    Jennifer Arrington
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    Sitting just atop the kidneys are our adrenal glands.  They have a difficult job, helping to direct our stress response system, our immune system, and our hormone output, and controlling inflammation in the body. Every time we experience a reaction to gluten, and our adrenals respond by sending out a surge of cortisol to help control inflammation, we are depleting our adrenal reserve.  When this happens chronically, over time, our adrenal system cannot keep up and becomes fatigued.  Symptoms of adrenal fatigue have far-reaching consequences throughout the body, including, of course, feeling fatigued and run down. But, adrenal fatigue can also affect our hormones, our blood sugar regulation, our mental acuity, our temperature regulation, and our ability to cope with food allergies, environmental allergies, and infections.
    Can the liver, the body’s largest internal organ, be affected by gluten intolerance too?  One example is autoimmune hepatitis, in which can be untreated celiac disease can be found in large numbers. Early screening testing for celiac disease is now strongly recommended for patients diagnosed with autoimmune hepatitis.
    The pancreas, which is key in blood sugar regulation, is highly affected by gluten intolerance.  Autoimmune disease triggers the development of Type I DM, and is becoming more closely associated with celiac disease.  Testing for celiac disease is now becoming a routine part of examination when a child develops Type I DM, and now that physicians are looking for celiac disease in juvenile diabetes, they’re finding it with greater frequency. Blood sugar regulation problems are also associated with non-diabetes hypoglycemia in those affected by gluten intolerance and appear to resolve with a low-glycemic gluten free diet.
    So, we’ve covered most of the body’s major internal systems. Now, let’s look at the extremities, our upper and lower limbs, where gluten-associated problems are also found. Ehlers-Danlos Syndrome, a collagen disorder resulting in shoulder, elbow, and wrist joints that dislocate easily (and other characteristics) is a genetic disorder that may also be associated with celiac disease.  I had mild symptoms of this disorder as a child, but never knew it had a name until I ran across it recently.  With a child who has this disorder, a simple game of swinging a child by the arms, or swinging a child between two sets of their parent’s arms, can result in a trip to the emergency to put their joints back into proper alignment. This is not to say that a reaction to gluten causes this genetic disorder, but that if you have a personal or family history of Ehlers-Danlos Syndrome, and symptoms that may be related to celiac disease, you should consider being tested.
    Rheumatoid arthritis is another of the autoimmune disorders associated with celiac disease, and often affects the fingers with crippling joint deformation. Other joints in the body can also be affected. Scleroderma is another terribly disfiguring and sometimes fatal autoimmune disorder affecting every part of the body. It is often first identified in the extremities, particularly the fingers. In scleroderma, normal tissue loses it’s flexibility as the body’s autoimmune response produces inflammation and an overproduction of collagen.  Collagen is the tough fibrous protein that helps form connective tissues including tendons, bones, and ligaments. Excess collagen is deposited in the skin and body organs, eventually causing loss of function.  Scleroderma can be associated with celiac disease.
    The arms and legs are also common spots for yet another autoimmune disorder, psoriasis, to develop.  Some patients with psoriasis are responsive to a gluten-free diet, but unfortunately, not everyone. Another skin condition that often shows up on the arms is dermatitis herpetiformis (DH), although this itchy blistering skin rash can occur in other places as well.  Common sites are the backs of the elbows and the backs of the knees, or on the lower legs.
    Peripheral neuropathy is a disorder that results in numbness, tingling, and sometimes severe nerve pain in the extremities.  Finger, hands, toes, feet, and lower legs may all be affected. Although usually associated with diabetes, peripheral neuropathy shows up fairly frequently in those with celiac disease, and is fortunately reversible on a gluten free diet supplemented by B-vitamins and some specific amino acids.  Peripheral neuropathy is usually associated with older people, but some of the cases I’ve observed recently have been in very young children who had severe malabsorption issues.  Fortunately they healed quickly and their neuropathy symptoms resolved completely.
    There a few last symptoms related to malabsorption that tend to show up in those with celiac disease or gluten intolerance.  Easy bruising and bleeding, either due to a deficiency of Vitamin K, or to an autoimmune platelet disorder, is one. Rickets, or osteomalacia – a softening of the bones in the legs related to vitamin D deficiency – is another. As we said before, inflammation goes along with celiac disease and gluten intolerance, and a common site for inflammation is the lower extremities.  Sometimes this can be profound, and trigger doctors to think heart disease, but it’s often unresponsive to Lasix and other diuretics. This condition, too, may also clear up on a gluten-free diet.
    As for me, I’ll be happy to be gluten-free, from head to toe.


  • Recent Articles

    Jefferson Adams
    Celiac.com 06/18/2018 - Celiac disease has been mainly associated with Caucasian populations in Northern Europe, and their descendants in other countries, but new scientific evidence is beginning to challenge that view. Still, the exact global prevalence of celiac disease remains unknown.  To get better data on that issue, a team of researchers recently conducted a comprehensive review and meta-analysis to get a reasonably accurate estimate the global prevalence of celiac disease. 
    The research team included P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green, CP Kelly, V Ahuja, and GK Makharia. They are variously affiliated with the Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lady Hardinge Medical College, New Delhi, India; Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway; Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Gastroenterology Research and Development, Takeda Pharmaceuticals Inc, Cambridge, MA; Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Department of Medicine, Columbia University Medical Center, New York, New York; USA Celiac Disease Center, Columbia University Medical Center, New York, New York; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
    For their review, the team searched Medline, PubMed, and EMBASE for the keywords ‘celiac disease,’ ‘celiac,’ ‘tissue transglutaminase antibody,’ ‘anti-endomysium antibody,’ ‘endomysial antibody,’ and ‘prevalence’ for studies published from January 1991 through March 2016. 
    The team cross-referenced each article with the words ‘Asia,’ ‘Europe,’ ‘Africa,’ ‘South America,’ ‘North America,’ and ‘Australia.’ They defined celiac diagnosis based on European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines. The team used 96 articles of 3,843 articles in their final analysis.
    Overall global prevalence of celiac disease was 1.4% in 275,818 individuals, based on positive blood tests for anti-tissue transglutaminase and/or anti-endomysial antibodies. The pooled global prevalence of biopsy-confirmed celiac disease was 0.7% in 138,792 individuals. That means that numerous people with celiac disease potentially remain undiagnosed.
    Rates of celiac disease were 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania; the prevalence was 0.6% in female vs 0.4% males. Celiac disease was significantly more common in children than adults.
    This systematic review and meta-analysis showed celiac disease to be reported worldwide. Blood test data shows celiac disease rate of 1.4%, while biopsy data shows 0.7%. The prevalence of celiac disease varies with sex, age, and location. 
    This review demonstrates a need for more comprehensive population-based studies of celiac disease in numerous countries.  The 1.4% rate indicates that there are 91.2 million people worldwide with celiac disease, and 3.9 million are in the U.S.A.
    Source:
    Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.

    Jefferson Adams
    Celiac.com 06/16/2018 - Summer is the time for chips and salsa. This fresh salsa recipe relies on cabbage, yes, cabbage, as a secret ingredient. The cabbage brings a delicious flavor and helps the salsa hold together nicely for scooping with your favorite chips. The result is a fresh, tasty salsa that goes great with guacamole.
    Ingredients:
    3 cups ripe fresh tomatoes, diced 1 cup shredded green cabbage ½ cup diced yellow onion ¼ cup chopped fresh cilantro 1 jalapeno, seeded 1 Serrano pepper, seeded 2 tablespoons lemon juice 2 tablespoons red wine vinegar 2 garlic cloves, minced salt to taste black pepper, to taste Directions:
    Purée all ingredients together in a blender.
    Cover and refrigerate for at least 1 hour. 
    Adjust seasoning with salt and pepper, as desired. 
    Serve is a bowl with tortilla chips and guacamole.

    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.
    So how, you may ask, is all this related to gluten? As a starting point, one report from the medical literature identifies a patient who developed aphasia after admission for severe diarrhea. By the time celiac disease was diagnosed, he had completely lost his faculty of speech. However, his speech and normal bowel function gradually returned after beginning a gluten free diet (8). This finding was so controversial at the time of publication (1988) that the authors chose to remain anonymous. Nonetheless, it is a valuable clue that suggests gluten as a factor in compromised speech production. At about the same time (late 1980’s) reports of connections between untreated celiac disease and seizures/epilepsy were emerging in the medical literature (9).
    With the advent of the Internet a whole new field of anecdotal information was emerging, connecting a variety of neurological symptoms to celiac disease. While many medical practitioners and researchers were casting aspersions on these assertions, a select few chose to explore such claims using scientific research designs and methods. While connections between stuttering and gluten consumption seem to have been overlooked by the medical research community, there is a rich literature on the Internet that cries out for more structured investigation of this connection. Conversely, perhaps a publication bias of the peer review process excludes work that explores this connection.
    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). 
    However, researchers really don’t have much data regarding the frequency and significance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. Such data could provide useful comparison information for patients with RCDII, among other things.
    To that end, a research team recently set out to try to get some information about the frequency and importance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. The research team included Shafinaz Hussein, Tatyana Gindin, Stephen M Lagana, Carolina Arguelles-Grande, Suneeta Krishnareddy, Bachir Alobeid, Suzanne K Lewis, Mahesh M Mansukhani, Peter H R Green, and Govind Bhagat.
    They are variously affiliated with the Department of Pathology and Cell Biology, and the Department of Medicine at the Celiac Disease Center, New York Presbyterian Hospital/Columbia University Medical Center, New York, USA. Their team analyzed results of TCR-GR analyses performed on SB biopsies at our institution over a 3-year period, which were obtained from eight active celiac disease, 172 celiac disease on gluten-free diet, 33 RCDI, and three RCDII patients and 14 patients without celiac disease. 
    Clonal TCR-GRs are not infrequent in cases lacking features of RCDII, while PCPs are frequent in all disease phases. TCR-GR results should be assessed in conjunction with immunophenotypic, histological and clinical findings for appropriate diagnosis and classification of RCD.
    The team divided the TCR-GR patterns into clonal, polyclonal and prominent clonal peaks (PCPs), and correlated these patterns with clinical and pathological features. In all, they detected clonal TCR-GR products in biopsies from 67% of patients with RCDII, 17% of patients with RCDI and 6% of patients with gluten-free diet. They found PCPs in all disease phases, but saw no significant difference in the TCR-GR patterns between the non-RCDII disease categories (p=0.39). 
    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. 
    Repeat biopsy showed that the clonal or PCP pattern persisted for up to 2 years with no evidence of RCDII. The study indicates that better understanding of clonal T cell receptor gene rearrangements may help researchers improve refractory celiac diagnosis. 
    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