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Gastrointestinal Symptoms Rating Scale in Coeliac Disease Patients on Wheat Starch-Based Gluten-Free Diets

Scand J Gastroenterol 2000 Sep;35(9):947-9
Lohiniemi S, Maki M, Kaukinen K, Laippala P, Collin P.
Dept. of Medicine, Tampere University Hospital, University of Tampere, Finland.

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

(Celiac.com 06/25/2000)

BACKGROUND: A wheat starch-based gluten-free diet is widely adopted in the treatment of coeliac disease, even though the products contain trace amounts of gluten. The aim here was to establish whether such a diet sustains abdominal symptoms.

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METHODS: The Gastrointestinal Symptom Rating Scale (GSRS) was applied to 58 coeliac disease patients on gluten-free diets and 110 non-coeliac controls. An estimate was made of daily dietary fiber and wheat starch-derived gluten. Psychological well-being was evaluated by a structured interview. Twenty-three coeliac patients consented to small bowel biopsy.

RESULTS: The mean GSRS score in coeliac disease patients did not differ from that in control subjects. Poorer psychological well-being was associated with abdominal symptoms in coeliac patients, whereas the daily amount of wheat starch had no effect on GSRS score. Overall dietary compliance was good, and villous atrophy was found in only 2 out of 23 patients. The average fiber consumption, 13 g per day, was lower than recommended.

CONCLUSIONS: Wheat starch-based gluten-free products are well-tolerated in coeliac disease patients, provided that their diets are otherwise strict.

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2 Responses:

 
Ursa Major
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said this on
15 Apr 2008 9:17:00 AM PDT
I don't agree with the above article. The author states that 'only 2 out of 23 patients had villous atrophy'. That is nearly ten percent! In my opinion, if ten percent of people with celiac disease will get villous atrophy from eating wheat starch, that proves that it is NOT safe.

 
RiceGuy
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said this on
01 Aug 2008 10:31:10 AM PDT
Since less than half the participants consented to a biopsy, then the percentage of villous atrophy would be even higher. Also, since the accuracy of the best tests is still very low, we don't know how many of the control group actually do have Celiac Disease. Additionally, there is no indication that ANY of the control group were biopsied. Since a considerable percentage of people with Celiac Disease display no symptoms, using that as the yardstick has a large margin for error. The non-Celiac group needed to undergo rigorous testing to be certain that they all are indeed not Celiac. And, since the Celiac patients did have psychological effects, which IS a symptom, then apparently they were better off without the wheat starch in their diet. Saying that the GSRS score didn't differ from that of the control group doesn't mean there wasn't any effect, but that both groups experienced similar effects.




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Might want to look into a keto diet, I have UC on top of celiacs and keto is working great Yeah I have major nerve and brain issues with gluten, gluten ataxia with nerve issues and brain issues. Seems to cause my body to attack my brain and nerve system. My brain stumbles fogs, and starts looping, the confusion causes me to become really irritable, I call it going Mr Hyde. Like my mind will start looping constantly on thoughts and not move driving me literally mad, or it used to. Now days it is primary the numbness anger but the gut issues and sometimes random motor loss limit me motionless to the floor now days for the duration of the major anger effects. Used to be a lot more mental then painful gut. I did a mental trauma post on it on while back where I came out about all my mental issues with gluten.

^^^^^^ good info, tips and tricks^^^^^^^^^ yes, crumbs will make you sick. also, breathing flour/pancake mix, etc that is in the air because eventually, you're going to swallow some.

Hello I was diagnosed Dec 15 of last year and went totally gluten-free the next day. I actually got worse before I got better - it's a steep learning curve - but now, 4 1/2 months later I'm finally seeing improvement. Hang in there.

Called my GI doctor today to make sure he is going to look at my small intestine and do biopsy for Celiac for my EGD and he is. Thanks for the tip everyone about have to start eating gluten again. The office told me to break my gluten free diet and start eating gluten everyday until my EGD. Here's to being miserable again for a few weeks ???

I can completely relate! The horrible mental effects that I have been living with for years is the absolute worst side effect of eating gluten, HANDS DOWN. Worse than the endless tummy aches, worse than the constant diarrhea, worse than the week long migraines, worse than the daily fatigue and body pain.... I honestly though there was something seriously wrong with me and hated my life because of how I felt mentally. I always felt like I was drowning, not in control of my thoughts, trapped in some unexplained misery. My head was always so cloudy, and I was mad because I always felt so slow and stupid. I would feel so lethargic and sad and empty while at the same time be raging inside, wanting to rip out of my own skin. I was mean, terrible, would snap at the people closest to me for no good reason and just felt like I hated everyone and everything. Think of how crappy you feel when you have a terrible cold and flu - I felt that crappy, but mentally. Some days were really bad, some were mild. I always thought it was because I was getting a migraine, or because I had a migraine, or because I had just overcome a migraine, because I didn't sleep well, because....always a random reason to justify why we have all these weird unrelated symptoms before we get diagnosed. I'm happy to say that I have been gluten-free for about 2 months now and though I am not symptom free, the first thing that improved was my mood. I no longer feel foggy and miserable. For the first time in years, my head is clear, I can actually think, and I feel positive and like I am in control of what's going on in my head. I don't hate the world. I don't spend every day bawled up on the corner of the couch depressed and angry. The release of these horrible symptoms is enough to never make me want to cheat, no matter what I have to miss out on. So insane how a little minuscule amount of a stupid protein can wreck such havoc.