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Increased Reflux and Irritable Bowel Syndrome in Celiacs Yields Lower Quality of Life


Study on quality of life in celiacs with IBD and acid reflux.

Celiac.com 03/04/2011 - Celiac disease is similar to the inflammatory bowel diseases, ulcerative colitis and Crohn’s disease, in the obvious sense that all are chronic inflammatory disorders of the gastrointestinal tract.  But more than that, they all also present daily psychological and social challenges to patients’ lifestyles.  In a recent study reported in the European Journal of Gastroenterology and Hepatology, researchers in the United Kingdom examined the prevalence of GI symptoms in patients with these diseases and correlated the incidence of these symptoms with quality of life (QoL).  Not surprisingly, they found that increased severity of reflux and irritable bowel syndrome were associated with a diminished QoL.  Patients with celiac disease had worse symptoms and QoL than those with ulcerative colitis, but they were better off than people with Crohn’s disease.

This cross-sectional study was performed by sending patients surveys through the mail.  One thousand and thirty-one people were included; 225 patients with celiac, 228 with ulcerative colitis, 230 with Crohn’s disease, and 348 healthy age- and sex-matched controls.  As this was a postal survey, there is a potential inclusion bias – it is possible that those patients faring the worst would be most likely to send back the questionnaires.  Seventy one percent of the celiac patients reported adhering to a gluten-free diet, but this was not corroborated endoscopically.  One of the surveys assessed physical and mental QoL and another considered depression and anxiety.  Participants were also asked to report and rate GI symptoms they had experienced over the past month, including reflux, heartburn, regurgitation, belching, dysphagia (difficulty swallowing), and retrosternal pain.

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Barrat et al. found that the celiac patients had higher rates of belching and dysphagia than inflammatory bowel diseases sufferers in this study and also than reported previously.  They highlight that despite the high (71%) degree of adherence to the gluten-free diet, 22% of celiac patients still reported severe enough IBS symptoms to affect their QoL.  They infer from this finding a couple of noteworthy things.  First, that the gluten-free diet may not adequately control IBS symptoms in celiac patients.  But also, that doctors are perhaps not inquiring about reflux and IBS during consultations, or patients are under-reporting their prevalence.  The authors thus suggest that QoL might be improved for these patients if doctors were more diligent in assessing them for reflux and irritable bowel syndrome.

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2 Responses:

 
tmm
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said this on
04 Mar 2011 4:20:03 AM PDT
Incredible that they'd call 71% GF a "high degree of adherence".
And then their solution isn't "tell them to BE GF!", it's "watch for treatable symptoms, probably resulting from the gluten".

I wish this article concluded w/ comments by Dr Gitig.

 
Hallie
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said this on
05 Mar 2011 11:19:12 PM PDT
Anyone with dysphagia, reflux, and diarrhea (with or without alternating constipation) really should be checked for the antibodies associated with scleroderma: antinuclear antibodies done by IFE methodology, and more specifically Scl-70, anticentromere, U1-RNP, RNA polymerase III and PM/Scl.




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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.