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  • Scott Adams
    Scott Adams
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    Wheat Starch-containing Gluten-free Flour Products in the Treatment of Celiac disease and Dermatitis Herpetiformis. A Long-term Follow-up Study

    Scand J Gastroenterol 1999 Feb;34(2):163-9
    Kaukinen K, Collin P, Holm K, Rantala I, Vuolteenaho N, Reunala T, Maki M
    Dept. of Medicine, Tampere University Hospital, Finland.

    BACKGROUND: We investigated whether wheat starch-based gluten-free products are safe in the treatment of gluten intolerance. METHODS: The study involved 41 children and adults with coeliac disease and 11 adults with dermatitis herpetiformis adhering to a gluten-free diet for 8 years on average. Thirty-five newly diagnosed coeliac patients at diagnosis and 6 to 24 months after the start of a gluten-free diet and 27 non-coeliac patients with dyspepsia were investigated for comparison. Daily dietary gluten and wheat starch intake were calculated. Small bowel mucosal villous architecture, CD3+, alphabeta+, and gammadelta+ intraepithelial lymphocytes, mucosal HLA-DR expression, and serum endomysial, reticulin, and gliadin antibodies were investigated. RESULTS: Forty of 52 long-term-treated patients adhered to a strict wheat starch-based diet and 6 to a strict naturally gluten-free diet; 6 patients had dietary lapses. In the 46 patients on a strict diet the villous architecture, enterocyte height, and density of alphabeta+ intraepithelial lymphocytes were similar to those in non-coeliac subjects and better than in short-term-treated coeliac patients. The density of gammadelta(+)cells was higher, but they seemed to decrease over time with the gluten-free diet. Wheat starch-based gluten-free flour products did not cause aberrant up-regulation of mucosal HLA-DR. The mucosal integrity was not dependent on the daily intake of wheat starch in all patients on a strict diet, whereas two of the six patients with dietary lapses had villous atrophy and positive serology.

    CONCLUSION: Wheat starch-based gluten-free flour products were not harmful in the treatment of coeliac disease and dermatitis herpetiformis.


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    GREAT SITE. I was diagnosed with so many auto immune diseases and had no clue. Through a visit to a naturpath and diligent research and work in my health I have lost the pain, inflammation and eye sores, intercytsial cystitis and so much more...pain from top of head to bottom of my toes so bad walking was nearly unbearable. Plus I have struggled with weight my whole life and I lost 30 lbs. and have kept it off by not eating gluten and sugar.

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  • About Me

    In 1994 I was diagnosed with celiac disease, which led me to create Celiac.com in 1995. I created this site for a single purpose: To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives. Celiac.com was the first site on the Internet dedicated solely to celiac disease. In 1998 I founded The Gluten-Free Mall, Your Special Diet Superstore!, and I am the co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.

  • Related Articles

    Scott Adams
    Gastroenterology 2005;129:797-806,1111-1113.
    Celiac.com 10/28/2005 – According to Dutch researchers, it may be possible to produce varieties of wheat that are safe for people with celiac disease. Dr. Spaenij-Dekking of Leiden University Medical Center and colleagues examined public databases that contained data on the many different varieties of wheat gluten proteins which can be found in wheat. Their goal was to identify the wheat varieties that contained the lowest levels of T-cell- stimulatory epitopes. The researchers found that the level of toxicity of the different types of wheat varies greatly, and the more ancient and grass-like the variety the less T-cell- stimulatory epitopes it contained, and conversely, the more modern the variety the greater its level of toxicity for those with celiac disease. They concluded that the use of selective breeding and screening could create a variety of wheat that is safe for those with celiac disease, and one that could prevent disease in those who are at risk.

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    Okay, thanks. Re: MTHFR - I don't really know yet... I only started reading about it yesterday and it is pretty overwhelming. But it does seem to be common advice that if you have a close relative with it you should be tested, and I guess having 2 copies of the "C" variant, as my sister has, is the "worst" variety of it.  It came to light for her when she was going through infertility and miscarriages.  They discovered that her homocysteine was high, which led to the MTHFR testing. So that is one thing I know I would then want to proceed to do, if I do have it - get my homocysteine tested. My dad died of early-onset Alzheimer's, and apparently there is a link between high homocysteine as well as the MTHFR mutation and Alzheimer's. It also seems like it would be worth knowing if I have it since it could be the cause of my lower levels of B12. And I guess maybe I would need to start taking methyl-folate? I mean, to answer your question, I am not entirely sure what I will do if I do have it.   Probably read a lot more about it... and take supplements like methyl-folate if I really think I need to.  Check my homocysteine & control that if I need to, hopefully to lower my risk of Alzeheimer's.  It seems like a frustrating area because there appear to be limited official medical websites that really even talk much about it (so far).  I have found one article on the NIH that focuses on the link with high homocysteine. I already eat a very healthy diet.  Whole grains, lots of fruit & veg, mostly organic.  I am a vegetarian except for very rare seafood. I avoid processed food and, above all, foods with added sugar...  To me, sugar is by far the worst culprit in the SAD.  I think RA has been ruled out by my 2 negative Rheumatoid Factor tests (one done several years ago, one just this year at my physical).  Also, the way this started in my elbows, and was really only there for years, is just... weird... and definitely doesn't really fit with arthritis.  And there is no swelling to speak of, just mild pain - sometimes aching, sometimes burning, sometimes sharp...  It may or may not fit with any systemic diagnosis versus a mechanical one, but nowadays I do also have pain in my hands, feet, and knees.  So then I think, well maybe it is/was something systemic, but it was worse in my elbows for some mechanical reason but now has progressed elsewhere.  I thought Crohn's was just digestive?  (Of course, many people think that of celiac.)  So I haven't really investigated that one much. My ANA was retested and is back down to "negative," so I think that pretty much rules out lupus.  I believe fibromyalgia is still on the table. Anyhow....  Your point is nonetheless taken.  I do want to rule out celiac and go from there.  At this point I'd sure love to find out it is something I could control through my diet!
    Hello, I've been suffering abdominal issues for about two months now. I've been having minor pain and a lot of pressure in my left abdomen. It feels almost like someone is inflating a balloon on my left side from below the belly button to just below the ribs. At first my doctor diagnosed it as diverticulitis, and put me on antibiotics, however a CT scan was never done. I was advised to stuck to a liquid diet followed by soft foods. I did start to feel better so I tried eating some pasta and toast and started to feel the pain and pressure again. My doctor then put me on stronger antibiotics and had me go back to the liquid and soft foods diet. Again I started to feel better and added in pasta and toast. Just like the first time the pain and pressure came back. My doctor then ran more bloodwork looking for other problems, including TGG IGA and TGG IGG. The TGG IGA came back <1.2 (negative), the TGG IGG came back 8.3 weak positive. My doctor thought that could point to potential celiac and ordered two more tests to look for celiac (I'm not sure which tests) and advised me to cut out gluten while waiting for the results.  I started researching celiac a little bit which is how I ended up here. I found a few things interesting. In the past 15 years I was diagnosed and treated for IBS, acid reflux, and chronic daily headaches with migraines. From the little research I've done it looks like all those could potentially be related to celiac. I'm anxiously awaiting the results from the new bloodwork, and hoping that I may be on the road to recovery! 
    For like $100 more, add the DGP IgA test as well.  The EMA is expensive because it is labor intensive (lab), so consider skipping that test.   Why find out if you have the MTHFR gene?    What is that knowledge going to do for you?  I have probably have the MTHFR gene.  My B-12 and Folate used to be off the chart when I was consuming soy milk that was fortified with cheap unmethylated forms of vitamins.    (I used soy milk before my celiac diagnosis because I was lactose intolerant).  I ceased all vitamin supplements and dropped any foods that were enriched  (or you can purchase more expensive methylated versions if you want to supplement) and those levels dropped down to normal levels.  I found that If I ate a normal healthy and varied diet and healed from celiac disease, I do not need supplements.   It appears that I was not able to process unmethylated vitamins because I might the MTHFR gene.  Just a theory.   Knowing I have the gene?  What is that going to do for me?  Will it change my behavior or save me from a new illness?  Can my doctor formulate treatments based on that knowledge?  Can he manipulate my genes?  NOT YET.  This might be beneficial in the future, but science is not there yet.  Just lots of websites trying to sell you vitamins.  Believe me, I have a family full of Autistic family members, so the MTHFR topic is of interest to me. Consider ruling out celiac disease first, address other issues that can impact joints like RA or Crohn’s), then eat a healthy diet that may or may not include gluten or processed food.  I have a friend who is on week three of the Whole 30 diet.  She ruefully confessed that she is feeling so much better.  In a few weeks, she will add foods back in that might be giving her issues.  I think she realizes that her Standard American Diet is not the healthy way to go.  Although she is happy about feeling significantly better, she is sad because she knows that she is going to have to give up all that junk food which seems to be making her sick.  I hope she moves forward because good health is priceless.      
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