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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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