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    Can Some Celiac Patients Drink Regular Beer?


    Jefferson Adams

    Celiac.com 06/17/2016 - What role does individual sensitivity play in celiac disease severity and reactions to gluten?


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    Researchers in Italy reported on an interesting case of a of a man with a clear diagnosis of celiac disease who nevertheless drank gluten-containing beer, with no physical symptoms, and no clinical issues.

    The research team included Fabiana Zingone, Ilaria Russo, Angelo Massari, and Carolina Ciacci. They are variously affiliated with the Department of Medicine and Surgery, and the Department of Clinical Pathology and Transfusion Medicine at AOU San Giovanni di Dio e Ruggi D'Aragona in Salerno, Italy.

    The team found that a 4-week period of drinking gluten-containing beer did not provoke significant changes in the intestinal mucosa of this patient with celiac disease nor did it elicit any relevant symptoms. Blood antibody levels rose, but did not reach a pathological threshold.

    It is of course possible that a longer gluten challenge might lead to symptoms and to clinically relevant changes in IgA antitransglutaminase levels. In this case, though, the patient seemed fine and showed no signs of an adverse celiac disease reaction, even though he drank standard non-gluten-free beer.

    Celiac cases like this may be uncommon, but they do show that individual gluten sensitivity can impact symptoms, immunological response and intestinal mucosa health differently, depending on the patient. They also teach us how much more we have to learn about celiac disease.

    Source: BMJ Case Reports 2016; doi:10.1136/bcr-2016-214686

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    Guest Ed Arnold

    Posted

    Is this article a snarky plant from the brewing industry??

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    Guest admin

    Posted

    Is this article a snarky plant from the brewing industry??

    I doubt it.

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    All I can say is that many gluten free people have beers of some sort and the topic is definitely hot. When I was diagnosed in UK in the 1970s we were told that gluten is too heavy to pass thru the distillation process. I do drink light beers and have specifically asked for a test a year ago for evidence for contamination in my diet and there were no signs in the blood of gluten antibodies. I have long wanted someone to assess barley gluten and see if there is some way it is seen in the body as different from wheat and rye (which give me reaction by just inhaling the dust from putting an open packet down on the counter!). They did find that oats are gluten free which they were not considered gluten-free for many years.

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    Guest Roxanne Mason

    Posted

    What would be considered a pathological threshold for the antibodies?

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    Guest Ronald E Lahr

    Posted

    I have had celiac disease for years and switched from beer to rum and coke for a while. I have a niece who went to commissary school in Vancouver and they spent a week on gluten free cooking. She said that beer has gluten in it but there are also"chemicals" in beer that counter act the gluten. I tried a couple of beers without any problems. I stay away from beers listed as wheat beers and have had no problems since. It is nice to be able to drink beer that doesn't cost over $9 a six pack.

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    Guest Jared M

    Posted

    I seem to have no issue with non-wheat beers. I stay away from German and Belgian beers. Lagers, pale ales, red ales, IPAs, stouts - I don't exhibit symptoms from drinking them.

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    Guest Lisa Purcell

    Posted

    I read somewhere that gluten was "theoretically" removed from beer during the distillation process. It would be interesting to have this beer drinking man with celiac disease be monitored as he ate or drank other items that have gluten.

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    Guest Mr Ducks

    Posted

    Is this article a snarky plant from the brewing industry??

    I can drink up to 32 oz. of beer, if I go over that I get sick.

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    Guest admin

    Posted

    I read somewhere that gluten was "theoretically" removed from beer during the distillation process. It would be interesting to have this beer drinking man with celiac disease be monitored as he ate or drank other items that have gluten.

    Beer is brewed and fermented, rather than distilled, but this process does remove most gluten.

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    Guest Bill R

    Posted

    I was diagnosed with celiac several years ago and was quite shocked, as I consumed beer, bread, and all the other wonderful things like pizza at a rate probably exceeding the average and never had any noticeable symptoms. I protested but the doctor said it was a triple confirmed diagnosis (visual scallops, biopsy, and blood work, in that order). I gave up real beer and haven't found any really good gluten-free beers but occasionally "cheat" with pizza or cake, and do not notice any change. If it wasn't for the increased risk of colon cancer and lymphoma I'd probably go back to eating a normal diet. Does anybody else not really have any symptoms despite a firm diagnosis of celiac?

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    Guest Linda

    Posted

    I find this article interesting. I am celiac but would love to enjoy a beer once in a while. I would love to see more research on this topic. For now I'm afraid to try any beers as I'm very sensitive to gluten.

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    Guest Roger

    Posted

    I am diagnosed celiac. I cannot eat gluten containing food, without severe pain, cramping, and diarrhea.One or two cookies or crackers, or one slice of bread, is all it takes.Yet I can handle beer fine. I only started a few months ago, I was afraid to try beer, but I was so tempted by all the flavored craft beers out there. My theory is that drinking beer may not be the same as ingesting food, because beer is drunk, rather than eaten, it might bypass the gut.

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    I'm sure it helps if the wheat/grains used in the making of the beer isn't from a GMO crop or sprayed with RoundUp.

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    Guest admin

    Posted

    I am diagnosed celiac. I cannot eat gluten containing food, without severe pain, cramping, and diarrhea.One or two cookies or crackers, or one slice of bread, is all it takes.Yet I can handle beer fine. I only started a few months ago, I was afraid to try beer, but I was so tempted by all the flavored craft beers out there. My theory is that drinking beer may not be the same as ingesting food, because beer is drunk, rather than eaten, it might bypass the gut.

    For the record beer does not bypass the gut, but the fermentation process does break down the gluten significantly.

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    Guest admin

    Posted

    I was diagnosed with celiac several years ago and was quite shocked, as I consumed beer, bread, and all the other wonderful things like pizza at a rate probably exceeding the average and never had any noticeable symptoms. I protested but the doctor said it was a triple confirmed diagnosis (visual scallops, biopsy, and blood work, in that order). I gave up real beer and haven't found any really good gluten-free beers but occasionally "cheat" with pizza or cake, and do not notice any change. If it wasn't for the increased risk of colon cancer and lymphoma I'd probably go back to eating a normal diet. Does anybody else not really have any symptoms despite a firm diagnosis of celiac?

    Many celiacs don't have symptoms, but must still adhere to a strict gluten-free diet to avoid the higher risk of cancer and other additional autoimmune diseases.

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    Guest frank

    Posted

    I drink the Redbridge...decent! Someone told me that Heineken lite could be imbibed without fear of gluten sensitivity (I was diagnosed but no symptoms). Any thoughts on this? I noted above people talk about drinking lite beers with no problem.

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    Scott Adams
    This statement is being distributed by Sapporo Breweries:
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    Frederik Willem Janssen is head of the Chemistry Department, Food Inspection Service in Zutphen, and a subsidiary of the Inspector of Health Protection (similar to the FDA in America). Their lab has a special interest in.... modified gluten, edible packaging materials (which may contain gluten), and detection of hidden gluten in foods, including the development of improved detection methods. He is also a member of the Medical/Scientific Advisory Committee of the Dutch Celiac Society.
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    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.

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    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

    Jefferson Adams
    Celiac.com 06/12/2018 - A life-long gluten-free diet is the only proven treatment for celiac disease. However, current methods for assessing gluten-free diet compliance are lack the sensitivity to detect occasional dietary transgressions that may cause gut mucosal damage. So, basically, there’s currently no good way to tell if celiac patients are suffering gut damage from low-level gluten contamination.
    A team of researchers recently set out to develop a method to determine gluten intake and monitor gluten-free dietary compliance in patients with celiac disease, and to determine its correlation with mucosal damage. The research team included ML Moreno, Á Cebolla, A Muñoz-Suano, C Carrillo-Carrion, I Comino, Á Pizarro, F León, A Rodríguez-Herrera, and C Sousa. They are variously affiliated with Facultad de Farmacia, Departamento de Microbiología y Parasitología, Universidad de Sevilla, Sevilla, Spain; Biomedal S.L., Sevilla, Spain; Unidad Clínica de Aparato Digestivo, Hospital Universitario Virgen del Rocío, Sevilla, Spain; Celimmune, Bethesda, Maryland, USA; and the Unidad de Gastroenterología y Nutrición, Instituto Hispalense de Pediatría, Sevilla, Spain.
    For their study, the team collected urine samples from 76 healthy subjects and 58 patients with celiac disease subjected to different gluten dietary conditions. To quantify gluten immunogenic peptides in solid-phase extracted urines, the team used a lateral flow test (LFT) with the highly sensitive and specific G12 monoclonal antibody for the most dominant GIPs and an LFT reader. 
    They detected GIPs in concentrated urines from healthy individuals previously subjected to gluten-free diet as early as 4-6 h after single gluten intake, and for 1-2 days afterward. The urine test showed gluten ingestion in about 50% of patients. Biopsy analysis showed that nearly 9 out of 10 celiac patients with no villous atrophy had no detectable GIP in urine, while all patients with quantifiable GIP in urine showed signs of gut damage.
    The ability to use GIP in urine to reveal gluten consumption will likely help lead to new and non-invasive methods for monitoring gluten-free diet compliance. The test is sensitive, specific and simple enough for clinical monitoring of celiac patients, as well as for basic and clinical research applications including drug development.
    Source:
    Gut. 2017 Feb;66(2):250-257.  doi: 10.1136/gutjnl-2015-310148.