Jump to content
  • Related Articles

    Jefferson Adams
    Celiac.com 11/09/2010 - Each year in the United States, millions of people undergo gastrointestinal (GI) endoscopic procedures. Generally, the procedures have been regarded as safe, with a physician-reported complication rate for endoscopies of just 7%.
    However, most systems, including the gastroenterology department at Beth Israel,  maintain a voluntary, paper-based physician reporting system wherein each gastroenterologist submits a monthly log describing any known complications.
    To get a better idea of actual numbers based on Emergency Room (ER) visits within two weeks of an endoscopy, Daniel A. Leffler, MD, of Beth Israel Deaconess Medical Center in Boston, set out with a research team to conduct a more in-depth review. 
    Their review of electronic medical records (EMR) showed that complications after endoscopy may be more common than previously thought.
    Dr. Leffler and his colleagues reviewed over 400 emergency department (ED) visits logged in one hospital's EMR system within two weeks of an endoscopic procedure.
    They found that nearly one-third of those visits were related to the previous endoscopy.
    Overall, they looked at records for follow-up visits for 6,383 esophagogastroduodenoscopies and 11,632 colonoscopies. The medical center's electronic reporting system showed 419 ED visits within two weeks of these procedures.
    The review team determined 32%, or 134 of these visits, to be directly related to the endoscopic procedure. Yet only about 7% of these were reported using the standard physician reporting system, the researchers said (P<0.001).
    The team also found that 29% of 266 subsequent hospitalizations were directly related to the patients' endoscopic procedure.
    Most of the ER visits were a result of abdominal pain (47%), gastrointestinal tract bleeding (12%), or chest pain (11%).
    By looking at actual electronic admission data, rather than relying on the more cumbersome physician reporting data, the research team found "a 1% incidence of related hospital visits within 14 days of outpatient endoscopy, 2- to 3-fold higher than recent estimates."
    This is important not just from a patient wellness perspective, but from a financial one. According to Medicare standardized rates, the average costs of endoscopic-related complications is $1403 per ED visit, and $10123 per hospitalization. Over the full screening and surveillance program, such complications added an extra $48 to each exam.
    The team's own words reinforce their conclusions: "Although the overall rate of severe complications, including perforation, myocardial infarction, and death remained low, the true range of adverse events is much greater than typically appreciated."
    Moreover, "standard physician reporting greatly underestimated the burden of medical care related to endoscopic procedures and unexpected hospital utilization," Leffler and colleagues wrote.
    With so many cases of celiac disease relying on biopsy via endoscopy, these numbers might be especially interesting to people with celiac disease, in addition to anyone else facing endoscopy in the future.
    Source:

    Arch Intern Med 2010; 170(19): 1752-1757

    Jefferson Adams
    Celiac.com 06/20/2013 - A restaurant owned by celebrity chef Jamie Oliver has been fined over $12,000 after a customer with celiac disease was sickened by eating regular pasta, instead of gluten-free pasta she was supposed to receive.
    The fine resolves a complaint brought by 38-year-old Kristy Richardson, who dined in 2011 at Jamie's Italian in Porstmouth, U.K. Richardson suffers from celiac disease.
    According to reports in the Telegraph, Richardson asked three different staff members to make sure she received gluten-free pasta, but she somehow received regular pasta. As a result, she became "violently ill," with nausea and vomiting that lasted for days and which left her weak for months, according to news reports.
    This in itself might be bad enough for most people, but, at the time, Richardson was on a waiting list for a heart and lung transplant. According to reports in the Sun, her gluten-triggered illness was so severe that her doctors temporarily removed her from that list; potentially depriving her of a transplant opportunity.
    Richardson complained, authorities became involved, charges were filed, and the restaurant eventually pleaded guilty to "selling food not of the nature, substance or quality demanded by a purchaser," according to the Telegraph.
    The fine is in addition to the nearly $4,000 previously awarded to Richardson in a civil case over the matter. What do you think? Should restaurants be fined if their gluten-free food contains gluten. Does it matter whether it makes people sick?

    Jefferson Adams
    Celiac.com 12/19/2014 - News that the Arizona Diamondbacks have traded starting pitcher Wade Miley to the Boston Redsox has been met with rumors that Miley’s trade was fueled, at least partly, by his refusal to adopt a gluten-free diet.
    So what’s the deal? Did gobbling gluten cost Wade Miley his job with the Diamondbacks?
    For his part, Miley, who was picked up by Boston last week, says he had butted heads this year with the Diamondbacks organization about not being gluten-free.
    "After a while, they left me alone," he said. "But it was always that elephant in the room."
    Without getting into specifics, Miley said that a gluten-free diet “might work for some people, but I didn't feel like it worked for me.”
    So, according to Miley, his refusal to go gluten-free was an issue. But, was it an issue that got him traded? Diamondbacks GM Dave Stewart says that Miley’s diet was “never once discussed” by the team in the run up to the trade.
    So, we may never know for sure just how much Miley’s refusal to give up gluten, or his attitudes about it, impacted his trade to Boston.
    What many may wonder is whether right-handers Rubby De La Rosa and Allen Webst, whom the Diamondbacks acquired in the trade, will be giving up their taste for those famously delicious toasted Boston-style subs when they come to Phoenix. Will they be going gluten-free?
    What do you think? Should a sports team be able to make its players eat a certain way? Is it healthier for athletes to eat gluten-free? 

    Jefferson Adams
    Celiac.com 02/23/2015 - There's an interesting article over at Mother Jones regarding the possible role that shorter rising times in most commercial bakeries might play in celiac disease and gluten-intolerance.
    In the article, author Tom Philpott interviews Stephen Jones, a wheat breeder at Washington State University, who points out that bread rising times in commercial bakeries has been cut from hours or even days down to just minutes, through the use of fast-acting yeasts and additives.
    What's more, Jones points out, commercial bakers add a lot of extra gluten to their products. Many supermarket sliced breads, especially whole-wheat breads include something called "vital wheat gluten" among the top four ingredients. Because whole-wheat flour has a lower gluten density than white flour, and to make the bread more soft and chewy, like white bread, commercial bakeries add extra gluten in the form of vital wheat gluten.
    So bakers are using more gluten and fermenting very rapidly, compared with traditional fermentation techniques that take up to 12 hours and more. By contrast, the team in Jones' laboratory, located in a rural stretch along Puget Sound has found that the longer the bread rises, the more the gluten proteins are broken down in the finished bread.
    It's certainly true that long fermentation reduces the amount of gluten in bread, and that long fermentation using strains of lactobacillus, as in many sourdough breads, breaks down even more of the gluten; in some cases, enough to be tolerated by people with celiac disease.
    Celiac.com has written about this in several articles on the future of long-fermentation sourdough, its tolerability and gut healing potential in people with celiac disease.
    However, Jones' notion that modern baking techniques, rather than modern wheat breeding techniques, are responsible for rising rates of celiac disease, and gluten-sensitivity remains unproven.

×
×
  • Create New...