22165 Do Adult Celiacs with Pancreatic Insufficiency Require Long-Term Enzyme Supplements? - Celiac.com
No popular authors found.
Ads by Google:

Categories

No categories found.


Get Celiac.com's E-Newsletter




Ads by Google:



Follow / Share


  FOLLOW US:
Twitter Facebook Google Plus Pinterest RSS Podcast Email  Get Email Alerts

SHARE:

Popular Articles

No popular articles found.
Celiac.com Sponsors:

Do Adult Celiacs with Pancreatic Insufficiency Require Long-Term Enzyme Supplements?


New research on pancreatic insufficiency and celiac disease.

Celiac.com 06/18/2010 - One of the conditions associated with celiac disease is called exocrine pancreatic insufficiency. A previous study showed that exocrine pancreatic insufficiency is the trigger for about one in three (20/66) cases of current or persistent diarrhea in adults with celiac disease. Of these 20 patients, 19 showed initial improvement with pancreatic supplementation.

However, at this point, there are no longitudinal studies on exocrine pancreatic insufficiency in the medical literature. A research team set out to rectify that by conducting their own longitudinal study. The team included Kate E. Evans, John S. Leeds, Stephen Morley, and David S. Sanders.

Over the next four years, the team conducted prospective follow-up checks on the 20 patients who received therapy for exocrine pancreatic insufficiency. The team assessed gastrointestinal symptoms, dietary adherence, celiac antibody status, and dose of enzyme supplementation. They repeated titters for fecal elastase-1 (Fel-1) to reassess exocrine pancreatic function.

The team was able to review 19 of the 20 patients; one patient had died. The group averaged 59.7 years of age. Seven subjects were male. On average, patients suffered from celiac disease for 13.2 years.

Ads by Google:

Eleven out of nineteen patients continued on enzyme supplementation, with average doses of 45,000 units of lipase per day. Only one of the eleven patients reported no reduction in symptoms, while eight of the 19 patients had discontinued the supplements after their diarrhea abated.

The entire group showed a substantial increase in Fel-1 levels over time, with median values of 90 lg/g at zero months, 212 lg/g at six months, and 365 lg/g at follow-up of 45–66 months (p/0.0001).

Fecal elastase-1 is helpful in spotting exocrine pancreatic insufficiency in adult celiac patients with diarrhea.

Results of the team's longitudinal survey indicate that that patients with celiac disease can end pancreatic enzyme supplementation as symptoms improve.

Source:

Celiac.com welcomes your comments below (registration is NOT required).





Spread The Word







Related Articles



Comments




Rate this article and leave a comment:
Rating: * Poor Excellent
Your Name *: Email (private) *:




In Celiac.com's Forum Now:

All Activity
Celiac.com Celiac Disease & Gluten-Free Diet Forum - All Activity

Exactly what are your allergy symptoms? Were they IgG or IgE? Allergy testing as a whole is not super accurate -- especially the IgG. Were you on any H1 or H2 antihistamines for the last five days when you were tested? As far as celiac testing, four days without consuming gluten probably would not impact testing.

I've been seeing my dr for a few weeks now about my stomach issues. We've ruled out the gallbladder and h-pylori and today I had the celiac blood tests done. From the reading I've done the past two days, it seems to me that it's highly likely that I have it. I've had digestive issues for years, but they've gotten progressively worse over the past 6 months or so. Pain and nausea when eating, bloat, eternal constipation, dh rash, at it's worse, tight cramp-like pain in a fist under my sternum, radiating through my back and around my right side keeping me up at night. Also heartburn/reflux and trouble swallowing, etc. Anyway, about 2 months ago, I needed a change. I didn't go to the dr immediately because it seemed pointless. (I've mentioned stomach ache when eating to drs before and been blown off.) So, I started the Whole30 elimination diet (takes out soy, grains, dairy, peanuts, and leaves you basically eating meat & veggies). Figured it would show me what I needed to take out of my diet and hopefully feel better. It worked- I felt great! And it seems that grains and gluten are my biggest offenders. But, now I've been off gluten prior to celiac testing. It's been 7 weeks. After 4 weeks I tested steal cut oats, that I later found out were probably glutened. And then nothing until yesterday. Yesterday I had 2 pieces of bread and a muffin and today I had two pieces of bread and then the blood test. Is this going to be enough to show up on the tests? My dr said that it would probably show up, since I had some yesterday and today and was currently having symptoms. But, google seems to say that I should be glutened for 2 wks straight before testing. Has anyone tested positive after just a little gluten? If it's negative should I insist on doing it again after weeks back on gluten? I feel awful, but do want clear answers. Obviously, gluten's not going to be a part of my life any more either way.

So just to clarify had not consumed any gluten for about 4 days before testing. I was assured by my allergist that it wouldn't affect the test. But what was alarming was that she retested my food allergies (my most recent reaction was two weeks ago) and every food allergy I have came back negative. I don't understand how that is possible. These food allergies developed when I was 20 and I am almost 24 now.

Thanks! You too! I have learned from this experience to take charge of my own health. It's nice at least that we can try the gluten-free treatment without a firm diagnosis or a doctor confirming the disease. I've also felt some of the gluten withdrawal symptoms, and my stomach pain ebbs and flows, but I'm determined to stick with the gluten-free diet to see what a difference it makes. Gemini, thank you! This was really validating and useful for me to hear. I've felt so confused through this process and just want some answers. If the biopsy results do come back negative, I'm going to follow your advice and do the gluten-free diet with repeat blood testing after a while. If they come back positive, well, then I'll have my answer. I'm supposed to get them back next week.

I have celiac and eosinaphalic esophagitis. I was put on a steroid inhaler recently. I use it like an inhaler but swallow the air instead of breathing it in. You may want to look into EOE and it's relationship to celiac. Just a thought. My swallowing and celiac seem to be related.