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  • Scott Adams
    Scott Adams

    How Common is Gluten Exposure in Patients with Celiac Disease on Gluten-Free Diets?

    Reviewed and edited by a celiac disease expert.

    Nearly 90% patients had at least one fecal or urine sample that was positive for gluten immunogenic peptides.

    How Common is Gluten Exposure in Patients with Celiac Disease on Gluten-Free Diets? - Image: CC BY-SA 2.0--Ark. Agricultural Experiment Station
    Caption: Image: CC BY-SA 2.0--Ark. Agricultural Experiment Station

    Celiac.com 04/09/2020 - Anyone with celiac disease knows how hard it can be to follow a gluten-free diet. Some studies have shown that even celiacs who strive to stay gluten-free are commonly exposed to gluten. How common is gluten-exposure in celiacs who are following a gluten-free diet? A new study takes a deeper look at real world gluten exposure in celiac patients following a gluten-free diet.

    To do so, the research team set out to measure levels of gluten immunogenic peptides (GIP) in fecal and urine samples from celiac patients on a gluten-free diet.

    Celiac.com Sponsor (A12):
    The research team included Juan Pablo Stefanolo, Martín Tálamo, Samanta Dodds, María de la Paz Temprano, Ana Florencia Costa, María Laura Moreno, María Inés Pinto-Sánchez, Edgardo Smecuol, Horacio Vázquez, Andrea Gonzalez, Sonia Isabel Niveloni, Eduardo Mauriño, Elena F. Verdu, Julio César Bai. They are variously affiliated with the Dr. C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires, Argentina; the Farncombe Family Digestive Health Research Institute, McMaster University Medical Centre, Health Sciences, Hamilton, ON, Canada; and the Research Institutes of Health, Universidad del Salvador, Buenos Aires, Argentina.

    The team conducted a prospective study of 53 celiac adults in Argentina who had followed a gluten-free diet for more than two years, and an average of eight years.

    The team used a celiac symptom index questionnaire to assess celiac-related symptoms for each patient at the beginning of the study. Patients in the study collected stool each Friday and Saturday and urine samples each Sunday for one month. The team used a commercial ELISA to measure gluten immunogenic peptides in stool and point-of-care tests to measure gluten immunogenic peptides in urine samples.

    Among other revelations, the results showed that nearly 40% of stool and urine samples were positive for gluten immunogenic peptides. Nearly 90% patients had at least one fecal or urine sample that was positive for gluten immunogenic peptides (median, 3 excretions). Nearly 70% of urine samples were positive for gluten immunogenic peptides at least once. 

    Positive gluten immunogenic peptides samples correlated with blood levels of deamidated gliadin peptide IgA, but not with levels of tissue transglutaminase. Interestingly, symptomatic patients had more weeks with detectable gluten immunogenic peptides in stool than patients without symptoms. 

    Patients with celiac disease on a long-term gluten-free diet are still frequently exposed to gluten. Tests to measure gluten immunogenic peptides in stool and urine could help dietitians ensure gluten-free diet compliance. In their celiac patients.

    In this real world study, nearly nine out of ten celiacs who are following a gluten-free diet tested positive for gluten exposure at least once in this study, and nearly two out of five urine tests was positive for gluten exposure. Moreover, these exposures may not have symptoms. This is pretty alarming news, to be honest. People with celiac disease need to avoid gluten, and they need a reliable way to check and see if they need to adjust their diet.

    Do you have celiac disease? Are you on a gluten-free diet? Do you think you get exposed to gluten regularly? Do you think that regular testing might help you to avoid gluten? Comment below.

    Read more in the Clinical Gastroenterology and Hepatology

    Edited by Scott Adams



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    Beacon60

    I too am benefitting from social distancing (USUALLY).  Our community has a large number of restaurants offering takeout and delivery.  We are all trying to help them survive the pandemic. So we are ordering out twice a week and cooking in the other 5 days.  So, alas there is still the opportunity for trouble.

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    Guest crystal shield

    Posted

    23 minutes ago, Beacon60 said:

    I too am benefitting from social distancing (USUALLY).  Our community has a large number of restaurants offering takeout and delivery.  We are all trying to help them survive the pandemic. So we are ordering out twice a week and cooking in the other 5 days.  So, alas there is still the opportunity for trouble.

    I rarely eat out.  When I do it’s common to have cross contamination and it’s not worth it.  

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    Guest Mary Sailors

    Posted

    I was diagnosed 7 years ago at age 63.  It was diagnosed during a routine endoscopy when the pathologist noticed that the cilia was blunted.  It took months to finally get a diagnosis.  Since then I have not eaten a single bite of gluten knowingly.  My problem is that I do not get the least bit sick if I get accidentally get some gluten.  This makes eating out very frustrating.  I have had waitstaff tell me that my food would be gluten-free and then bring my salad with croutons.  They then say "Well, I don't know what Celiac or gluten-free means!"  This means I cannot trust anyone except myself and my husband.  Scary situation!  So our solution is that we rarely eat out.

    Another subject:  Since my diagnosis, I have put on a ton of weight.  I am hungry all the time.  I especially crave sweets.  Anybody else doing this?  Solutions?  Any help would be VERY much appreciated.

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    Retired Librarian/Teacher

    When I was first diagnosed about 3 years ago, there was so little gluten free food, that I started loosing weight.  Then, I started finding gluten-free cookies and crackers, and I started gaining.  I think there is a mindset of: I can't eat very many things, so I'll eat a lot of those things I can eat, so I'm not hungry.  That does put on weight.  

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    Guest FrenchFried

    Posted

    On 4/16/2020 at 10:52 AM, Scott Adams said:

    GliadinX is definitely not a joke and a lot of research has been published about AN-PEP and how it can break down small amounts of gluten in the stomach, before it reaches the intestines.

    Please make sure you don’t also have a POTATO ALLERGY when consuming GliadinX. 

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    docaz
    16 hours ago, Guest FrenchFried said:

    Please make sure you don’t also have a POTATO ALLERGY when consuming GliadinX. 

    Indeed, the flow agent maltodextrin that is in GliadinX is potato derived. Sometimes that component is wheat derived but the potato source was chosen (even if the wheat derived option is also considered gluten-free because of the purification) to avoid any concern of gluten contamination. I do not know how common potato allergies are but if someone is allergic to potatoes, then this is a consideration. 

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  • About Me

    Scott Adams

    Scott Adams was diagnosed with celiac disease in 1994, and, due to the nearly total lack of information available at that time, was forced to become an expert on the disease in order to recover. In 1995 he launched the site that later became Celiac.com to help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives.  He is co-author of the book Cereal Killers, and founder and publisher of the (formerly paper) newsletter Journal of Gluten Sensitivity. In 1998 he founded The Gluten-Free Mall which he sold in 2014. Celiac.com does not sell any products, and is 100% advertiser supported.


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