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Normal Growth & Nutrition for Asian Celiacs on Gluten-Free Diet

Celiac.com 11/22/2007 - Faced with a lack of data on growth rates and histological recovery in Asian children with celiac disease, a team of doctors led by Surender K. Yachna set out to evaluate the result of a gluten-free diet.

The study findings appear in the Journal of Gastroenterology & Hepatology. The research team looked at forty-two children with celiac disease.

The team chronicled weight and height as weight for height (WFH) and height standard deviation scores (HSDS) deviation scores. 25 of the 42 children underwent duodenal biopsies after 1 and 2 years, while 14 of the children underwent a third biopsy after being on a gluten-free diet for 3-7 years. The research team measured compliance with a gluten-free diet in the children using regular interviews & IgA anti-endomysial antibody estimation (EMA).

The average HSDS was 3.3 + 1.6 with 76% showing an HSDS of <-2, with 60% of the children undernourished, with an average WfH of 81.6 + 5.7.

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Over an average follow-up span of 3.7 years, the HSDS improved significantly to -1.3 + 1.7, with 84% of cases achieving normal nutrition. The average growth rate was 13.9 cm for the first year, and 5.6 cm in the following years.

The small bowel biopsies conducted upon diagnosis revealed Marsh IIIb subtotal villous atrophy in 18, or 72%, of the patients, and partial villous atrophy in 7, or 28%. Follow-up biopsy after 1-2 years revealed a change to partial villous atrophy in 17 of the 18 who originally showed Marsh IIIb subtotal villous atrophy. One patient showed a normal biopsy. All 7 patients who originally showed partial villous atrophy showed improvement.

81% of the patients showed negative results for IgA endomysial antibody. Follow-up biopsies conducted after 5 years of Gluten-free Diet showed improvement to Marsh I-II, but no normalization.

From these results, the team concluded that most children with celiac disease exhibit normal nutritional uptake and growth patterns with the introduction of a gluten-free diet, and that most also show significant improvement in small bowel histology, but none show normalization, even after 5 years of a dedicated gluten-free diet.

Journal of Gastroenterology Hepatology. 2007; 22(8): 1300-1305

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3 Responses:

 
Dr.Kapil Kumar Juneja
Rating: ratingfullratingfullratingfullratingfullratingfull Unrated
said this on
02 Dec 2007 12:10:31 AM PDT
Doctor, please do a service for Asian celiacs. please list the gluten free medicines available in India &amp; other Asian countries so that they can have them without any fear. Drug companies are not giving any details at all for the fear of exaggerated response by public.

 
Wafaa Kandeel
Rating: ratingfullratingfullratingfullratingfullratingempty Unrated
said this on
12 Dec 2007 11:55:05 AM PDT
It is my pleasure to read article like this . I have had celiac disease for 11 years . I hope to send any updates and articles about this disease to my e- mail.

 
Bakura

said this on
11 Jul 2008 3:48:11 AM PDT
Colloidal silver helped me a lot here. 2 teaspoons a day should work. I usually create about 2 tea-spoons of it, and mix it with my green tea (for best effects try it with oolong). It will repair any existing damages done by gluten to the villi and the cellular-lining of the small intestine and will literally HALT the problems within days, as well as replenish overall-body health, clean column as well as unblock neural pathways. Colloidal silver by record has treated over 650 diseases (even ancient Mayans, native indians, and Egyptians have been using it for ages). It is THE ancient medicine. Please let others who have celiac be aware of this. Gluten is toxic in nature and is usually found in (wheat, rye, barley) Commercial packed food or beer (which wheat dwells in) has a lot
of gluten in it. A permanent avoidance of all things which contain wheat or gluten will help a lot. Good luck.




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I am very interested in this too. My daughter tested negative for celiac, but has terrible primarily neurological symptoms. Because she tested positive for SIBO at the time and was having some GI symptoms, I was told it was just a Fodmap issue. I knew better and we have been gluten free for 2 years. Fast forward to this February. She had a SIBO recurrence that I treated at home with diet and herbal antibiotics because I couldn't get the insurance referral. She was doing great. Then stupid me brought in gluten containing chick feed for the new baby chicks we got. Feed dust everywhere. Total mess. Really, no GI symptoms (she was SIBO free by then)...but the neurological symptoms! my daughter couldn't walk for three days. Burning down one leg, nerve pain in the foot. Also heaviness of limbs, headache and fatigue. Better after three days. But unfortunately she had a TINY gluten exposure at that three day mark and had another severe reaction: loss of balance, loss of feeling in her back and arms, couldn't see for a few seconds, and three days of hand numbness, fatigue, concentration problems. Well, I actually contacted Dr. Hadjivassilou by email and he confirmed that the symptoms are consistent with gluten ataxia but any testing would require a gluten challenge. Even with these exposures, antibodies would not be high enough. His suggestion was maintain vigilance gluten free. I just saw my daughter's GI at U of C and she really only recognizes celiac disease and neurological complications of that. But my impression is that gluten ataxia is another branch in the autoimmune side of things (with celiac and DH being the other two). At this point, I know a diagnosis is important. But I don't know how to get there. We homeschool right now so I can give her time to heal when she is accidentally glutened, I can keep my home safe for her (ugh, that I didn't think of the chicken feed!) But at some point, she is going to be in college, needing to take exams, and totally incapacitated because of an exposure. And doctors state side that are worth seeing? Who is looking at gluten ataxia in the US?

Caro..............monitoring only the TSH to gauge thyroid function is what endo's do who don' t do a good job of managing thyroid disease. They should do the full panel and check the actual thyroid hormone numbers.........T3 and T4. The importance of the TSH comes second to hormone levels. In order to track how severely the thyroid is under attack, you need to track antibody levels.......not the TSH. I did not stay with endocrinologists because I found they did not do a very good job and found much greater help and results with a functional medicine MD. You should not have a goiter if your thyroid is functioning well and your TSH is "normal". Maybe they should do a full panel? Going gluten free can have a profound affect for the better on thyroid function and that is something that is becoming more and more accepted today. Ask most people with Celiac and thyroid disease and they will tell you that. My thyroid never functioned well or was under control under after I discovered I had Celiac and went gluten free. It was the only way I got my antibody numbers back down close to normal and they were around 1200 when it was diagnosed with Celiac. I was diagnosed with Hashi's long before the Celiac diagnosis. I am not sure Vitamin D has anything to do with thyroid antibodies but who knows? Maybe it does have an affect for the better. It is really hard to get Vitmain D levels up, depending on where you live. Mine are going up, slowly, even after 12 years gluten-free but I live in the Northeast in the US and we don't have sun levels like they do in the South. I take 5,000 IU daily and that is a safe level to take, believe it or not. I get no sun on my job so the large dose it is! Having Celiac Disease should not stop you from being able to travel, especially S. America. I travel, although I do agree that some countries might be very difficult to be gluten free in. You can be a foodie and travel with Celiac so no worries on that front. You may not be able to sample from someone else's plate, unless they are eating gluten-free too but I have had awesome experiences with food when traveling so you can too!

I don't know what you drank or where.... so here are a few thoughts. - sure, a dive bar might have dirty glasses and serve a cocktail in a beer glass? But a nice reminder place, with a dishwasher, should be fine. If it's a sketchy place, Stick to wine, then it's served in wine glasses that aren't used for beer or bottled ciders in the bottle. - ciders on tap might, just a slight chance, have an issue. Because of beer on tap, mixed up lines, etc. - you may have a problem with alcohol - you may have issues with The high sugar content of the drink. I know I have similar issues if I drink serveral ciders of extra sugary brands - are you positive it was a gluten-free drink? Not this " redds Apple" pretending to be a cider - it's beer with apple flavor. Or one of those " gluten removed " beers?

Hi Stephanie, I'm also from the UK, I've found this site more helpful than anything we have! As already mentioned above, in my experience it could depend on what and where you were drinking. Gluten free food and drink isn't always (not usually) 100% gluten free as you may know, maybe you have become more sensitive to even a trace of gluten that is probably in gluten free food/drink. Is it possible you have a problem with corn, particularly high fructose corn syrup that is in a lot of alcoholic drinks? This was a big problem for me and the only alcoholic drinks I can tolerate are William Chase vodka and gin. I contacted the company last year and all their drinks are 100% gluten and corn free, made the old fashioned way with no additives, so maybe try their products if you like the occasional drink and see how you get on. If you drink out, not many pubs sell their products but I know Wetherspoons do and smaller wine bars may too. l was never a spirit drinker but I must say their products are absolutely lovely! Very easy on a compromised gut too considering it's alcohol. I second the suggestion on seeing a natural health practitioner. I've recently started seeing a medical herbalist, as I've got nowhere with my now many food intolerances since going gluten free last year and I've noticed a difference in my health already.

Sorry for the very late reply and thanks for the replies, I didn't get a notification of any. In case anyone else comes across this and has been wondering the same as I was, I did try a vegetable broth and I did react to it in the same way as if I'd eaten the vegetables. As for the candida, I've been using coconut oil and am seeing a medical herbalist for this and leaky gut. It's only been a few weeks but I've noticed an improvement all round.