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  • Scott Adams
    Scott Adams

    Persistent Mucosal Abnormalities in Coeliac Disease are not Related to the Ingestion of Trace Amounts of Gluten


    Scand J Gastroenterol 1999 Sep;34(9):909-14
    AW Morrow Gastroenterology and Liver Centre, Dept of Histopathology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.

    SPECIAL NOTE: European Codex Alimentarius quality wheat starch was used in this study.

    (Celiac.com 06/25/2000)

    BACKGROUND: It is expected that in patients with coeliac disease the small bowel mucosal mucosa will return to normal if they adhere to a gluten-free diet (GFD). However, in many this is not the case. This study aims to determine whether this persistent villous atrophy (VA) could be due to continued ingestion of the trace amounts of gluten in gluten-free foods, as defined by the WHO/FAO Codex Alimentarius.

    METHODS: Duodenal biopsy specimens from 89 adults with long-standing coeliac disease were examined, and the findings correlated with their form of gluten-free diet.

    RESULTS: In 51 subjects the duodenal specimen was normal, whereas in 38 there was villous atrophy (partial, 28; subtotal, 8; total, 2). There was no relationship between the presence or absence of VA and ingestion of either a GFD as defined by the Codex Alimentarius (Codex-GFD; 39 patients) or a GFD that contained no detectable gluten (NDG diet: 50 patients). Intraepithelial lymphocyte counts were higher, and lactase levels lower, in subjects with an abnormal biopsy specimen than in those in whom it was normal. However, within each of these biopsy groups there was no difference in these variables between patients on a Codex-GFD and those on an NDG-GFD. IgA antigliadin antibody was detected in 4 of 29 patients on a Codex-GFD and in 3 of 13 on a NDG-GFD (NS).

    CONCLUSION: The persistent mucosal abnormalities seen in patients with coeliac disease on a GFD are not due to the ingestion of trace amounts of gluten. The consequences of these abnormalities have yet to be determined.


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    This is the conclusion I've come to after eliminating almost all packaged, bottled and boxed foods and solely eating vegetable, fruits, and seafoods. Now and then I have coffee but I'm hoping that's not bad. So far the ingestion and discomfort is mild or minimum but I've noticed the indigestion is still current. It's difficult to break down beef and large portions of food even when I'm craving/hungry for that amount. So this tidbit of an article does make sense and confirm that I'm not getting 'mysterious' gluten traces from my coffee...hopefully not, and that I need to pursue this diet I'm on to heal my guts. But for how long?

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    I'm glad I found this article. I am still having slight symptoms. It really bothers me but I also feel that it takes 3-6 years to heal and I'm not there yet. Also, my symptoms are as much from my diabetes I think (peripheral neuropathy).

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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.

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