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    Dog Detective Sniffs Out Gluten


    Jefferson Adams

    02/01/2011 - Imagine having a dog that was specially-trained to sniff out even the tiniest amounts of gluten in food and warn you ahead of time. There are scores of people with celiac disease severe enough that the slightest trace of gluten can make them painfully ill. Hollie Scott is one of them. Scott is a University of Missouri College of Veterinary Medicine student is also lucky to have her dog Elias is a champion Beauceron and a gluten-detecter extraordinaire. The handsome Beauceron comes from a 400-year-old breed that became almost extinct serving as messenger dogs in Europe during two world wars. Even though he is just only 2 years old, Elias is the first male Beauceron to receive the title AKC Grand Champion. His full title is: GCH CH Elias Mes Yeux Vigilants RN. But Elias' regular job is working as a gluten-detection service dog for his twenty-two year old owner, Scott, a first-year student in the program.


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    To become so accomplished at gluten-detection, Elias spent weeks in Slovenia undergoing intense gluten-detection training, and now he can detect and warn her away from anything containing gluten, hot or cold, in all its many forms. Teaching a dog to be alert to the scent of gluten is more challenging than other scent-detection training, precisely because gluten comes in so many forms. When it's time for Elias to do the sniff test for Scott, she places a cover with holes over the item, and the dog takes a sniff. If Elias smells gluten, he tries to pull the item away from her; if it's safe, he just looks away. To help Elias keep his edge, Scott tests him daily with known gluten-containing foods, and adds in products she hopes are gluten-free.

    Scott was diagnosed with celiac disease about two years ago after spending much time "in and out of hospitals" She's now acutely vigilant about checking labels and trying to avoid cross-contamination. "You can't drop your guard for even a minute," says Scott, who likens an attack to "a really extremely bad case of stomach flu" from which her body doesn't recover fully for nearly three weeks. That's where Elias works like a charm.


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    Guest Angie Halten

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    Cool story! Would have never thought a dog could sniff out gluten. I need to get me one of those dogs! Or maybe find a way to train my dog to do that!

     

    Angie.

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    How cool! I have a scent hound... I need to send her to that gluten-detection training in Slovenia!

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    TRULY AMAZING! JUST LOVE READING YOUR DIVERSE REPERTOIRE OF STORIES! THANK YOU!

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    Guest fuschiacat

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    Where do you get a dog like this? I would like to have one.

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    I love my dogs but they do tend to drool...rather avoid the food altogether over eating gluten-free dog drooled food!

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  • Related Articles

    Kim Hopkins
    Plan your meals:  It sounds simple, but it’s one that is often ignored.  Sit down before you do your weekly grocery run.  Know what you are going to make for each meal including snacks.  Find out what’s on sale before you make your weekly meal plan.  Stick to the list when you shop! Develop a file of dependable, go to gluten-free recipes.  My people report that, when they are short on time, that’s when they are likely to make extravagant purchases.  Take the thinking and guess work out of meal planning by looking through your file.  You can even write down the estimated cost of the meal. Eat foods that are naturally gluten free found at the regular grocery store.  Corn tortillas are cheap and have many uses, including for sandwich wraps.  Beans are a nutrient-rich starch substitute, as are lentils. Eat whole foods.  Whether you are gluten-free or not, it is healthier not to eat packaged, processed foods.  Just because a product is marked gluten free doesn’t mean it’s good for you.  Processed gluten-free products often lack nutrients.  Limit these to a couple times per week or less. Eat foods that are in season.  This means they had to travel less far to reach your grocery store, therefore they will be cheaper. Grow your own.  Learn how to can and/or jar the extras.  Live in a cool climate?  Some veggies can be started inside. Make a soup.  Soups are filling, and they are a great way to use up items in the fridge. Eat more vegetarian and vegan meals.  Eliminating meat from two dinners per week will save you quite a bit of money. Eat breakfast for dinner.  Make a frittata – cook 3 strips of bacon in a skillet.  Set aside and drain off most of the fat.  Add diced onions.  Cook for 5 minutes.  Add diced red pepper.  Cook another 5 minutes.  Add a package of thawed, drained frozen spinach.  Salt and pepper to taste.  Add bacon back in.  Beat 5 eggs and pour them all over the filling.  Top with cheese and bake at 350 for 8 – 12 minutes, or until the eggs are set.  Serves 2 – 3. Get creative.  For thickening sauces or gravy, substitute equal amounts of cornstarch for flour.  Mashed potato flakes also make a great, inexpensive thickener and binder in place of breadcrumbs. Xanthan gum is used in many gluten-free recipes to serve as the “glue” to hold the product together; use 2 tsp. unflavored gelatin to replace 1tsp. xanthum gum in some recipes such as cookies. Cornmeal or crushed potato chips can be substituted when a recipe calls for a coating or crunchy topping. Buy in bulk.  Once you found something you like, save big by buying in a large quantity.  The Gluten-Free Mall  has bulk discounts and many other ways to save you money. See their "Shop Smart & Save Money!" section on the top-right corner of their site.
    Create or join a bulk buying group.  Ask around at your local support group, or link up with local folks online.  If you like the same products buy a bulk order and split it. Cook ahead and freeze meals in individual or family-size servings.  If you are not someone that cooks and you are watching your budget, it makes sense to learn. Invest in a good vacuum food sealer.  This will help keep leftovers fresh for longer = less waste. Bake 1-2 times per month.  Things like Pizza crusts, bread, and pie crusts will freeze well if wrapped properly. Make gluten-free cookie dough from scratch and freeze in a roll.  Cut and bake what you need.  This will curb your desire to buy an expensive mix. Start a gluten-free dinner swap (like a holiday cookie swap).  Get a few families to cook up a large quantity of gluten-free meals and swap them for variety! Join a food co-op.  Co-ops are groups who use their purchasing power to get lower prices. Make your own blend of gluten-free flours ahead of time and store in an air tight container. To prevent contamination, purchase extra appliances (like a toaster) from Craig’s List or Goodwill. Track your purchases.  Seeing it in black and white can be very revealing. Consult with your employer’s human resources department.  Do they offer a flexible spending account (FSA) benefit?  These accounts hold your money pre-tax for medical purchases.  If so, will the FSA recognize gluten free food (and related shipping charges)?  Get it in writing!  If your employer doesn’t offer this benefit, ask them to look into it.  This will save you about 30%. If you are not using an FSA and you spend a lot of money on medical expenses, consult with your accountant.  Are a portion of your gluten-free food purchases tax deductible?  Shipping charges often can be reimbursed from this account, as can mileage to and from specialty stores.

    Dr. Vikki Petersen D.C, C.C.N
    This article originally appeared in the Spring 2010 edition of Celiac.com's Journal of Gluten-Sensitivity.
    Celiac.com 10/22/2010 - More and more we’re hearing from frustrated patients who, despite being vigilant about their gluten-free diet, continue to suffer health problems.
    I have been involved in the field of celiac and gluten sensitivity for over 15 years and am delighted by much of the recent increased awareness and attention given to the area.  But I’m also concerned about the lack of assistance given to many patients who have been definitively diagnosed with either celiac disease or gluten sensitivity.  While being correctly given the advice to not eat gluten, they are not provided with a follow-up program to address and treat the secondary effects of gluten sensitivity.  This oversight condemns many to ongoing ill health.
    The focus of this article is on the types of conditions we see clinically with our patients, some of the recent research that corroborates our findings, and steps you can take to address the underlying root cause of these problems.

    Leaky Gut
    Also known as increased intestinal permeability, a leaky gut refers to a loss of integrity of the lining of the small intestine.  Recall that the small intestine is approximately 23 feet in length and has the surface area of a tennis court.Gluten, in the sensitive individual, is a known cause of leaky gut, but in a perfect world the elimination of gluten would allow healing to occur resulting in an intact, healthy intestinal lining.
    Alas, we do not live in a perfect world and other factors contribute to the health of the gut.  Infections in the form of parasites, amoebas, bacteria, and the like, can certainly contribute to continued increased permeability.  Likewise, other food reactions, chief among them dairy, can cause persistent irritation and thereby prevent healing.  Imbalance of the beneficial bacteria or microbes that comprise the microbiota of the intestine, as well as nutritional and pancreatic enzyme deficiencies, are also suspected to limit healing.
    Let’s take a look at each of these individually:

    Infections
    Whether one has celiac disease or is gluten sensitive, one thing is for sure, one’s immune system has been overtaxed due to the presence of gluten in the diet.  Depending on the age at diagnosis, it is often several decades of stress that the immune system has undergone.Such an overburdened immune system is unable to be as vigilant as a healthy one and as a result it allows such organisms as parasites, amoebas or bacteria to infiltrate the body.  Some estimates suggest that the digestive tract is normally exposed to a pathogenic organism every 10 minutes.  A healthy intestinal immune system is able to identify and eradicate those organisms as part of its normal activities.  An unhealthy immune system often “misses” such organisms and they happily take up residence in the small intestine.
    Interestingly, some of these organisms create crypt hyperplasia and villous atrophy that appears the same as that caused by gluten.  Imagine the frustration of a patient who is being told by their doctor that they are not following their diet when indeed they are.  What’s being missed?  The presence of an infectious agent.
    In the 2003 American Journal of Gastroenterology, researchers reported a large percentage of small intestinal bowel overgrowth (SIBO) in celiac patients with persistent GI symptoms despite adherence to a gluten-free diet.  These patients were off gluten, as instructed, but were still having diarrhea due inhospitable organisms in their intestines.
    This segues nicely into the next area I want to discuss – dysbiosis or imbalance of the friendly bacteria in the small intestine.

    Dysbiosis
    The population of organisms found in the intestines of celiac patients (treated with a gluten-free diet or not) is different from that found in healthy control groups.  The ratio of good bacteria to bad was found to be reduced in celiac patietnts regardless of whether their celiac disease was active or inactive.  Because the “bad” bacteria are pro-inflammatory in nature, they can be responsible for creating some of the initial problems with celiac disease, as well as helping to perpetuate them despite following a gluten-free diet.In the August 2009 Scientific American, Dr Fasano made a very interesting statement regarding these microbes or probiotics as relates to the age of initiation of celiac disease.  He stated: “Apparently they [probiotics] can also influence which genes in their hosts are active at any given time.  Hence, a person whose immune system has managed to tolerate gluten for many years might suddenly lose tolerance if the microbiome changes in a way that causes formerly quiet susceptibility genes to become active.  If this idea is correct, celiac disease might one day be prevented or treated by ingestion of selected helpful microbes.”
    Isn’t this fascinating?  If you haven’t read the complete article I encourage you to do so, but it is sufficient to say there is scientific discussion that entertains the notion that a healthy microbiome or probiotic population is not only anti-inflammatory (a good thing to help prevent many diseases) but may actually act as a “switch” that turns on and off the expression of certain genes.
    Therefore, part of our program is to examine the population of the microbiome through laboratory testing, and supplement as needed, to support a healthy anti-inflammatory population.  In the past we typically prescribed probiotics only for a few short months following the eradication of a pathogenic organism.  But in the last several years it has become clear that our patients’ clinical profile is much more stable with continued probiotic supplementation.

    Dairy Sensitivity
    It can be difficult to confront major changes in one’s diet.  Removing gluten is definitely a big challenge and sometimes my patients look at me forlornly when I simultaneously recommend the elimination of dairy products.  I try to encourage them by promising that organic butter is allowed and by quickly recommending my favorite coconut ice cream, as well as cheese and milk substitutes.Contrary to the passing thought that I wish to be cruel, there is excellent documentation to back up what we’ve seen clinically for years - gluten and dairy are truly not our friends.
    The majority of the world’s people are lactose intolerant.  Populations such as Asians, African Blacks, those of Jewish descent, Mediterraneans, Mexicans and North American Blacks all exceed 70% intolerance to lactose. 
    Note that many drugs and supplements may contain lactose as well, so be vigilant.
    Estimates suggest that we retain the enzyme to digest our human mother’s milk for 2 to 5 years and after that milk from any mammal is likely toxic because it’s too high in protein and phosphorus, making proper digestion impossible.  Human milk is very low in protein but rich in essential fatty acids.
    Casein, a protein from milk, is strongly associated with allergic reactions.  Therefore putting lactose and casein together presents double jeopardy to the body.  In this country, milk contains more toxins per gram than any other food, so you can see that there’s great cause for concern.
    Earlier we spoke of leaky gut.  Dairy stops the formation of glucosamine in the intestine making it one of the primary causes of leaky gut.
    I could expand on this further but perhaps we’ll save that for a future article.

    Nutritional Deficiencies
    When we eat, the ultimate goal is that the food will be broken down into components that can be assimilated into the bloodstream and delivered as fuel to all our trillions of cells.  Discovering that one is sensitive to gluten and eliminating it goes a long way toward achieving this goal.  However, some vitamins and minerals should be tested to ensure that their levels are normalizing on a gluten-free diet.  Otherwise good health may be a fleeting target.Folic acid, vitamin B12, Iron and Vitamin D levels are all very important to measure.  Supplementation is often needed to optimize the levels of these substances.  Follow-up testing ensures that this objective has been achieved or maintained and should be part of a comprehensive program.
    Discovering that you’re gluten sensitive and following the diet should be rewarded with dramatically improved health.  If that is not the result, other problematic factors need to be isolated and treated.  Such a program is not difficult and is well worth the effort.
    Please let me know if I can answer any further questions.
    To your good health!


    Jefferson Adams
    Celiac.com 01/26/2012 - A Canadian woman is fighting a battle with the government of British Columbia to protect the services that allow her 18-year old daughter to live at home in Quesnel, B.C., with 24-hour care — much of it provided by Shelley McGarry herself.
    The woman's daughter, Chelsea McGarry already has a long list of challenges — Down syndrome, autism, early onset Alzheimer's disease, diabetes, and celiac disease, among other conditions.
    The problem is that Chelsea turns 19 in December, at which point her responsibility for her care transfers from Ministry of Children and Family to Community Living B.C., the government agency that provides services to adults with developmental disabilities.
    Shelley McGarry says she's been battling for months with Community Living B.C. According to McGarry, Community Living B.C. has refused to approve the a plan for Chelsea. Moreover, the agency has threatened to reduce the minimal care Chelsea now receives, McGarry says.
    "It just turns my stomach to think of taking this public," she said. "But I don't know where else or what else to do."
    Independent provincial politician Bob Simpson and B.C. Representative for Children and Youth Mary Ellen Turpel-Lafond both say Chelsea's case is a classic example of Community Living B.C.'s failure to work with families and find solutions. Instead, they say, the agency is worsening the McGarrys' situation.
    "This is a young woman whose life is in crisis," said Turpel-Lafond, who has been pushing Chelsea's cause since her family since Ausgust 2011, when they asked him to advocate on her behalf. Turpel-Lafond says that Community Living B.C.'s efforts have been lacking so far.
    "I've written, I've met with the head of CLBC, I've done just about everything I can," she says. "I've said to them very clearly, 'This is a case that needs a review by you, she added'"
    Simpson represents Chelsea and her family in the provincial legislature. He says that the family has followed all of the government's rules.
    Shelley McGarry has thoroughly documented Chelsea's fragile medical conditions. She developed a plan with the local non-profit society, also known as a micro-board. McGarry arranged for Chelsea to receive home care for about $340,000 a year. That amount is far less than the CLBC's plan to put Chelsea in a care home capable of managing her complex needs.
    Simpson called the plan that the McGarry's have offered the CLBC a 'very reasonable and appropriate plan.'
    However reasonable that plan may be, the CLBC has refused to approve it. Worse still, their proposed alternatives would either be unsafe, or cost up to three times what it would to keep Chelsea at home, Simpson said.
    Simpson says that he suspects the CLBC is punishing Shelley McGarry for her vocal and tireless advocacy on Chelsea's behalf. Simpson adds that he also suspects  that officials, as he says they have done in other recent cases, have lost sight of Chelsea as a person.
    Both Social Development Minister Stephanie Cadieux and Community Living B.C. have declined to comment on specific cases. However, Cadieux said in an interview that she is aware of the file, and that she has appointed a new client support team, which she hopes can resolve the matter.
    "I agree that it needs attention," Cadieux said, adding that the new team includes a number of "high-ranking officials" from the Ministry of Social Development, and the Ministry of Children and Family Development.
    Source:

    http://www.canada.com/Disabled+woman+faces+battle+government+care/5593715/story.html

  • 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