Jump to content
  • Sign Up
Celiac.com Sponsor:


Celiac.com Sponsor:


  • Join Our Community!

    Get help in our celiac / gluten-free forum.

  • Jefferson Adams

    Mortality Rates for Celiacs with Persistent Villous Atrophy Similar to Those with Healthy Guts

    Jefferson Adams


    Reviewed and edited by a celiac disease expert.

    Celiac.com 02/06/2013 - Villous atrophy (VA) in the small intestine is one of the prime features of celiac disease, and has been associated with increased mortality, but it is unknown if mortality is influenced by mucosal recovery.

    CC--Leo ReynoldsTo better understand the relationship between mucosal healing and mortality in celiac disease, a research team set out to determine whether persistent villous atrophy is associated with mortality in celiac disease patients.



    Celiac.com Sponsor:




    The research team included B. Lebwohl, F. Granath, A. Ekbom, S.M. Montgomery, J.A. Murray, A. Rubio-Tapia, P.H. Green, and J.F. Ludvigsson. They are variously affiliated with the Celiac Disease Center at the Department of Medicine of Columbia University College of Physicians and Surgeons in New York, NY, the Clinical Epidemiology Unit at the Department of Medicine of Karolinska University Hospital and Karolinska Institutet in Stockholm, Sweden.

    The team used biopsy reports from every pathology department (n = 28) in Sweden to identified 7,648 individuals with celiac disease, which they defined as the presence of villous atrophy, and who had undergone a follow-up biopsy within 5 years of diagnosis. They used Cox regression to assess mortality according to follow-up biopsy.

    Celiac patients were 28.4 years of age, on average, and 63% were female. The average follow-up after diagnosis was 11.5 years. Overall, patients who underwent follow-up biopsy had lower mortality rates than those who did not undergo follow-up biopsy (Hazard Ratio 0.88, 95% CI: 0.80-0.96).

    Of the 7648 patients who underwent follow-up biopsy, 3317 (43%) showed persistent villous atrophy. In all, 606 (8%) patients died. However, patients with persistent villous atrophy died at about the same rates as those with mucosal healing (HR: 1.01; 95% CI: 0.86-1.19).

    Also, children with persistent villous atrophy showed no increase in mortality (HR: 1.09 95% CI: 0.37-3.16) or adults (HR 1.00 95% CI: 0.85-1.18), including adults older than age 50 years (HR: 0.96 95% CI: 0.80-1.14).

    Mortality rates for celiac patients with persistent villous atrophy are about the same as for celiac patients with healthy guts. So, persistent villous atrophy is not tied to higher mortality for celiac disease patients. That means that even though a follow-up biopsy will help doctors to spot refractory disease in symptomatic patients, persistent villous atrophy is not useful in predicting future mortality.

    Source:


    User Feedback

    Recommended Comments

    So I interpret this to mean that a little accidental gluten may not be good for you, but it most likely won't cause any damage that will kill you. It apparently didn't trigger any other diseases that would kill you either. I wonder if the "not dead" celiacs with villous atrophy had as good a quality of life as those who had mucosal healing.

    Share this comment


    Link to comment
    Share on other sites

    Interesting! I continue to have villous atrophy in the absence of gluten in my diet (my TTG test is now negative). Not all guts heal completely, especially those guts where the celiac disease took decades to diagnose. Nice to know that my imperfect villi may not take me out of this life early after all!

    Share this comment


    Link to comment
    Share on other sites

    It may not affect the length of life to have some villous atrophy, however I'm wondering about quality of life.

    I believe that a little "accidental gluten" is a slippery slope. Is 20ppm not outside the amount that's accidental? How much is too much accidental?

    Share this comment


    Link to comment
    Share on other sites

    So this means I am not going to die if I eat some gluten... therefore like most things in life, by exposing myself to a small amount of something that in large amounts would hurt me, I create some level of immunity to the ill effects. I was diagnosed aged 6 months old, now 47, I do not follow the diet strictly and I believe I have a much better quality of life. However, having interesting discussions with people more recently diagnosed who believe that absolute abstinence is the right way... they may be right but I have yet to see any medical evidence... thoughts?

    Share this comment


    Link to comment
    Share on other sites


    Join the conversation

    You are posting as a guest. If you have an account, sign in now to post with your account.
    Note: Your post will require moderator approval before it will be visible.

    Guest
    Add a comment...

    ×   Pasted as rich text.   Paste as plain text instead

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,500 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

  • Related Articles

    Scott Adams
    Gastrointest Endosc. 2004 Jan;59(1):116-8. Celiac.com 06/28/2004 - This study, although small, indicates that there may be additional damage to the second part of the duodenum caused by celiac disease, and that this can also be used for a marker for diagnosing the disease:

    Dickey W, Hughes D.
    Department of Gastroenterology, Altnagelvin Hospital, Londonderry, Northern...

  • Celiac.com Sponsor:

  • Forum Discussions

    Just wondering what vitamins people were advised to take after diagnosis? I am anemic so think I need to improve my iron, presuming low on b12 and D but am yet to have full vitamin checks. Obviously will have these checked soon.  Of ...
    I have used Bio-K.  It is certified gluten-free and was recommended by my now retired doctor.  It can be found at my local health food store market.   https://www.biokplus.com/en_us/products  
    Hi all, Does anyone know of or wish to start a support group in Bergen County, NJ?  Or are there any members in Bergen Co who would just like to get together now and then and support each other in person?  
×
×
  • Create New...