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Researchers Hunt Causes of Non-responsive Celiac Disease

Celiac.com 03/18/2009 - A recent study used lactulose hydrogen-breath assays to show that small intestine bacterial overgrowth (SIBO) is likely a routine cause of non-responsive celiac disease.

A team of researchers from the Mayo Clinic College of Medicine recently set out to assess the rates and significance of SIBO in celiac disease based on the results of quantitative culture of intestinal aspirate.

The team was made up of Alberto Rubio-Tapia, M.D., Susan H. Barton, M.D., Joseph A. Murray, M.D., of the Mayo’s Division of Gastroenterology and Hepatology, and Jon E. Rosenblatt, M.D., of the Mayo’s department of Laboratory Medicine and Pathology. Their efforts were supported by the American College of Gastroenterology (ACG) International Training Grant 2006 (ART) and the NIH grants DK-57892 and DK-070031 (JAM).

Currently, the rate of SIBO in celiac disease diagnosed by quantitative culture of intestinal aspirate is not known. The team set out to assess the rate and determine the significance of SIBO in celiac disease based on the results of quantitative culture of intestinal aspirate.

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The team set out to examine the causes of non-responsive celiac disease by looking at people with celiac disease in whom culture of intestinal aspirate was assessed for the presence of both aerobic and anaerobic bacteria. They defined bacterial overgrowth as culture >105 colony forming units/mL.

In all, they evaluated 149 people with biopsy-confirmed celiac disease. They took intestinal aspirate samples from 79 (53%) patients with non-responsive celiac disease, 47 (32%) as initial work-up for mal-absorption, and in 23 (15%) with asymptomatic treated celiac disease.

The team diagnosed 14 cases of SIBO (9.3%), nine cases of non-responsive celiac disease (11%), five cases at initial work-up for mal-absorption (11%), and 0 cases in asymptomatic treated celiac disease. Patients with a positive culture showed signs of worse mal-absorption. 67% of patients with both non-responsive CD and bacterial overgrowth showed a coexistent disorder.

The results showed that nearly 1 in 10 celiac patients had SIBO as diagnosed by quantitative culture of intestinal aspirate (9.3%). This figure included both patients with symptomatic treated or untreated CD. This shows that SIBO may exist along with other maladies associated with non-responsive celiac disease.

Journal of Clinical Gastroenterology: Volume 43(2)February 2009pp 157-161

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4 Responses:

 
barbara l. frazier
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said this on
25 Mar 2009 5:25:41 AM PDT
This is the best site for gluten free information. Thank you for making it available to us.

 
Deborah Cox
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said this on
25 Mar 2009 5:36:10 AM PDT
Very informative - I have biopsy-confirmed celiac as well.

 
Kathleen Schweiker
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said this on
25 Mar 2009 6:13:25 AM PDT
Would like more information. What other conditions were present among comorbid and asymptomatic patients, particularly if any were diagnosed with Chron's disease.

 
Janis
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said this on
25 Mar 2009 7:45:36 AM PDT
Does SIBO cause bad breath and 'coverage of stuff' on your tongue that I have to use a tongue scarper on daily.




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You may find these interesting, they're from Professor Marios Hadjivassiliou, a leading expert on gluten ataxia: http://www.acnr.co.uk/pdfs/volume2issue6/v2i6reviewart2.pdf Best of luck helping your daughter

Yep. The one that is most relevant I think is the post by Backtalk. Backtalk went back on gluten and have to a colostomy done on an emergency basis. Not fun. She regretted ignoring the gluten-free diet.

Welcome Lochella Hopefully you can draw some comfort from finally having an answer and thus starting the path to good health. Healing is going to come from your own body as you progress on the gluten free diet and it stops fighting itself and starts repairing that damage. You're still in the very early days and it's not an instant process sadly. 6 months is the usual figure bandied around for seeing significant improvement, although hopefully you'll get some signs of improvement much quicker than that. The single best thing you can do is to eat good simple whole foods and make sure absolutely no gluten gets into your diet. There's some tips here: With stomach pains peppermint tea is my go to drink. Avoiding caffeine seems to help as well as its rough on digestion at the best of times. This may be a time to ease up on alcohol as well and consider dropping dairy, many find they're lactose intolerant but this can correct itself in time. You will find lots of good info, advice and support here, I hope the community is of help to you as it was to me. Best of luck!

I recently got diagnosed with Celiac disease I must of had it my whole life. I'm 35 I've always had severe stomach problems, in and out of hospitals and misdiagnosed until now. My small intestine is severely damaged I'm now waiting to see a dietitian and my specialist wants to see me again in 2 weeks. How do some of you deal with the pain of the healing process and what helps you? I'm in so much pain?

I recently got diagnosed with Celiac disease I must of had it my whole life, in 35 I've always had severe stomach problems in and out of hospitals and misdiagnosed until now. My small intestine is severely damaged in now waiting to see a dietitian and my specialist wants to see me again in 2 weeks. How do some of you deal with the pain of the healing process and what helps you? I'm in so much pain?