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    Scott Adams

    Recovery from Celiac Disease - The New England Journal of Medicine

    Scott Adams
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    Celiac.com 03/19/2002 - The following excerpts were taken from The New England Journal of Medicines January 17, 2002 (Vol. 346, No. 30) article on recovery from celiac disease:



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    In addition to a gluten-free diet, all patients with newly diagnosed celiac sprue who have clinically evident malabsorption should initially receive a multi-vitamin preparation and appropriate supplements to correct any iron or folate deficiency. Patients with steatorrhea, hypocalcemia, or osteopenic bone disease should receive oral calcium and vitamin D supplementation.

    Approximately 70 percent of patients have symptomatic improvement within two weeks after starting a gluten-free diet. The speed and eventual degree of histologic improvement are unpredictable but invariably lag behind the clinical response and may not be evident on repeated biopsy for two to three months. Although a return to normal histologic findings is common in children, half of adults have only a partial resolution on biopsy. If a patient has no response to the diet, the most common cause is incomplete adherence. Persistent symptoms may be caused by coexisting disorders such as irritable bowel syndrome, lactose intolerance, microscopic colitis, or pancreatic insufficiency.

    In one study strict adherence to a gluten-free diet reduced the risk of all disease-associated cancers including enteropathy-associated T-cell lymphoma. Thus, it seems prudent to recommend lifelong strict adherence to a gluten-free diet in all patients with celiac sprue.

    Regarding untreated celiac sprue:
    Dairy products should be avoided initially because patients with untreated celiac sprue often have secondary lactase deficiency. After three to six months of treatment, diary products can be reintroduced if the patient has no ill effects.

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  • About Me

    Scott Adams was diagnosed with celiac disease in 1994, and, due to the nearly total lack of information available at that time, was forced to become an expert on the disease in order to recover. In 1995 he launched the site that later became Celiac.com to help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives.  He is co-author of the book Cereal Killers, and founder and publisher of the (formerly paper) newsletter Journal of Gluten Sensitivity. In 1998 he founded The Gluten-Free Mall which he sold in 2014. Celiac.com does not sell any products, and is 100% advertiser supported.


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