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Cutaneous Gluten Sensitivity

Journal of Gluten Sensitivity Spring 2017 Issue


Image: Dr. Rodney Ford

Celiac.com 04/26/2017 - "The universe is made of stories, not atoms" — Muriel Rukeyser

Helen, a woman with severe lifelong eczema/dermatitis, wrote to me a few weeks ago, saying "I have taken your advice and been strictly gluten free for five months now. The eczema inflammation is 99% gone and my skin quality has significantly improved. I do still get a bit itchy around my neck area and elbow creases, more so at night when it is warm.

I have noticed a significant improvement in my asthma also. I still use antihistamines perhaps once or twice a week for runny nose. Does this mean I will need to be gluten free for life? Which of your books would you say would be the most relevant for someone in my position? Thank you for your assistance, regards, Helen.

I recommended eBook: "Dermatitis Eczema: Gluten Wheat – Solving the eczema puzzle." Available at: http://www.GlutenEczema.com

This is an excerpt from the chapter: "Children better off gluten/wheat".

To help you get a better idea of how gluten can trigger eczema, here are narratives of some children whose eczema got better when their gluten sensitivity was recognised and treated. Most had good remission of their eczema on a gluten-free diet. Their stories told by their parents.

To give context to the blood test values, the normal reference ranges were:

  • AGA: 0–15
  • tTG: 0–20

Celiac disease with bad eczema
Lily at five years old was diagnosed by me with celiac disease. Symptoms: eczema. Run down, pot tummy and slow growth. Tests: All of her blood tests were positive for celiac disease (tTG 120) and she had an abnormal intestinal biopsy which confirmed the bowel damage of celiac disease. AGA very high (115).

Her mum said:

"Lily has now been gluten-free for the last year. She came to see Dr. Ford to investigate her allergies. She had a blocked nose and troublesome eczema. She also had quite a pot tummy and Dr Ford said that her growth was slow (she was thin and short). Dr Ford said that she needed blood tests for gluten and celiac disease: these were both positive. So she had an endoscopy, which was abnormal, showing the villus blunting of celiac disease. Therefore, she had to go on a gluten-free diet."

"Since she has been gluten-free over the last year, she has gotten better and better. She no longer has lots of infections, she has more energy, and interestingly, her allergies have nearly gone away. Her skin used to give her a lot of trouble – she had a lot of bad eczema. Her eczema now is very much better and she only has small amounts left in her creases. And if she has any gluten errors it flares up."

Recovering from gluten-eczema
Isabella, at two years old, was recovering from her eczema. I asked her mother what happens if Isabella has any gluten. Her mum said:

"Isabella had eczema all over her body. She was on strong steroid creams. She had the positive blood tests for gluten antibodies (AGA of 66), so it was suggested I take her off the gluten. I did this."

"I took her off gluten and it has cleared her eczema up. Now, when she does eat anything with gluten in it she gets little patches of eczema on her legs. I just can't believe it!"

Blood all over her sheets
Emily was three years old. She had a high anti-gliadin antibodies (AGA 48) but she did not have celiac disease (normal tTG). Her mother told me:

"Initially her skin was really sore, dry and scratchy. She would have blood all over her sheets in the morning from scratching while she was asleep. Her poos were really sloppy and nasty."

"But after taking gluten out of her diet her skin cleared up within days, and the itchiness of her skin settled. She was just so much happier."

Dry skin and worsening eczema
Breanna and Alyssa, twins aged 3 years. Symptoms: eczema and poor sleeping. Both had high AGA levels (60 & 68) and normal tTG levels (5 & 3). They did not warrant an endoscopy.

Mum writes:

"My twins were born at 26 weeks. During our stay in NICU they developed very dry skin, at times you felt like you wanted to peel the dry skin off. The word eczema was mentioned on more than one occasion. There is a history of eczema and asthma in our family, so at the time I tried to deny all knowledge of that word."

Dry skin and worsening eczema
"Eleven weeks later we took our twins home. Their skin was still dry and we were given a moisturiser to use as required. As time went on their skin didn't improve and eventually at around the age of one year they showed real signs of eczema. We started to use steroid creams: 1% Hydrocortisone to start with, then onto a much stronger steroid cream. Soon, this stronger cream was used all the time to control their eczema as the other creams were of no real help."

"At around 2 years old, while at a playgroup session one of the mothers was talking about her daughter's eczema and how she had gone to see Dr Ford and now there were no signs of it there today. Of course my ears pricked up. I was interested to hear how her diet affected her skin and the word gluten was mentioned."

At the time it didn't mean a lot to me. Therefore, I made an appointment and I was excited to think that we might be able to change the girls' diet and their skin condition may improve.

They had positive gluten blood tests
"The day arrived and we had our first visit. He talked to us about this gluten thing and that if we could avoid it then their skin might make a dramatic improvement. I was keen to try anything. Firstly, they had to have some skin prick allergy tests – it showed a reaction to wheat among a few other things. Next, the girls had a blood test confirming that they definitely had an allergy to gluten, and their iron levels were also very low. The final step was to set about changing their diet. I can honestly say that this was daunting to start with but once we got our heads around the issues, it became second nature."

Sleeping at last!
"One of the biggest changes we have noticed is that they are now sleeping so much better. I was constantly up and down to them all night and was getting so worn out now we can almost guarantee a full nights sleep, Yahoo!! The other major issue was the steroid cream use: we haven't used the strong steroid cream for 12 months. So for me, going gluten-free was a huge step in the right direction."
Gluten-free gets easier

"There are heaps of products that we can use and the staff in shops were very helpful with information and getting stock in. I have since brought a number of cook books all with sections on gluten-free that have been helpful. When baking or cooking, I now just do it the gluten-free way and everyone in our family eats it with no complaints. We have all adjusted accordingly."
"Our thanks goes out to Dr Ford for all his help. I also send good luck to all of you who are about to embark on a gluten-free diet – the rewards will be well worth the sacrifice."

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Sharon

Losing her hair – alopecia
Ella, age 6 years. Symptoms: eczema, alopecia, moody, abdominal pain, multiple food allergy. AGA high (49), tTG normal (3), EMA negative, Small bowel biopsy, normal.

Mum writes:

"Ella is now age 6 years. At age 3 years Ella started to lose her hair. After a year of scalp treatment, by the time she turned 5 years old, all but one small patch had regrown."

Losing her hair
"About 4 months later a small patch of alopecia reappeared and her hair loss rapidly progressed from there. At this time her eczema, always present in a mild form, worsened and became almost impossible to control. Many forms of treatment were tried and all failed. Within the year Ella had lost all her hair and was constantly itching. Over this time Ella also complained of tummy pains and weight loss."

Diagnosed as gluten-sensitive
"As her father has celiac disease, we decided to get Ella checked. Her blood test was positive but the biopsy was negative for celiac disease. In discussion with the GP and some unanswered questions we eventually had an appointment with Dr Ford. After this appointment, Ella started on a strict gluten-free diet and has remained on it for the past 4 months."

Amazing results
"The results are amazing. Ella has stopped most of her scratching and she is far more comfortable. Ella's mood has changed and she is now a very happy little girl. Best news of all is that she has started to have a small amount of hair growth."

"At no time, despite the variety of people seen and the fact that they were aware of family history, did anyone suggest getting Ella tested for celiac disease. It was purely parents at the end of their tether, pushing."
Sue

She was getting worse eczema
Tessa, age 2 years. Symptoms: eczema, poor growth, multiple food allergy. Tests: AGA high (51), tTG normal (7), Biopsy not done.

Mum writes:

"Tessa was our first-born baby. She weighed a healthy 8lb and was breastfed until 6 months. I introduced solids at 5 months. Having given a bottle of expressed milk every night since she was 10 weeks, I found that she preferred this and weaned herself."

Eczema at the time of solids
"Tessa had eczema from the time she commenced solids, but it was manageable with mild steroid ointments. However, at six months her eczema became more distressing for her. She had her first course of antibiotics at this age."

"We felt that we were using more and more topical steroids, oral antibiotics, and even a course of oral prednisone. None of these treatments felt satisfactory to her family. We needed a solution to prevent the problem. Not only was her skin getting worse but also she was quietly losing weight. A friend suggested visiting Dr Rodney Ford."

Allergies to egg, dairy and peanuts
"Our first visit involved an extensive medical history and allergy testing. Tessa was found to be allergic to egg, dairy, peanut, grass, and cats. We excluded the food allergens from her diet. But, over the next four months Tessa had a dramatic weight loss, going from the 50 percentile to falling off the Child Health nurse growth graph. She required more steroids, and antibiotics."

Waking screaming
"My angel baby, who had slept through the night from age 6 weeks, was now 16 months and woke every night screaming inconsolably. We were getting desperate, putting in an awful lot of work by eliminating dairy and egg with no rewards. With a new baby due to be born Tessa's exhausted parents needed answers. Back to Dr Ford we went. He suggested running some blood tests to check her gluten markers. It came back that her Anti-Gliadin Antibody was 51, suggesting that she was gluten-sensitive."

Gluten-free as well!
"We trailed a gluten-free, egg-free, and dairy-free diet. This was a totally overwhelming prospect for our family, as at that time we were introducing a two-week-old baby to the world! Luckily, Tessa's father, who too is an adult sufferer of eczema, was able to take all this on board and went off grocery shopping, bringing back lots of acceptable goodies. It was also at this time that I learnt of the real benefits of living in a small town."

We had a gluten-free buddy
"We were very fortunate that another mother of gluten-sensitive children took me by the hand grocery shopping, showing me how easy it is! Also, the church where we regularly attend made a whole week's worth of meals for the freezer which all fitted the requirements for Tessa's diet. All this really just through word of mouth!"

At last she is better
"We are so excited to see such an improvement. She has just been allergy tested again and we are able to introduce egg and dairy again. I had been giving small amounts of dairy already, hoping that she would have grown out of this. At one point all she would eat was cheese, so to get some calories into her that is what we fed her. Having Tessa on a gluten-free diet requires us to be organized and creative. It is especially difficult when you spontaneously decide to go out for the day: there are no guarantees that we will find appropriate food for Tessa, so usually we pack a lunch."

Gluten-free is expensive
"The food that is gluten-free is also usually twice the price of other foods. We have had to learn to bake, which is something I still struggle with. We have had some major disasters, especially baking cakes. Whenever it seems too difficult, and we are out of ideas, it is not too hard to find a reason to keep trying."

Improved gluten free
"Our little girl has significantly improved since becoming gluten-free. She has not required antibiotics or oral steroids for eczema since commencing the diet. We can now apply the topical steroid ointments as prescribed "sparingly". She no longer gets up in the morning, her pyjamas and sheets covered in blood, and forehead weeping. She can play in sandpits without fear that the sand will get into her sores, and once again they will be infected."

"We are so lucky that something so simple as changing Tessa's diet has had such a dramatic affect on her life."
Mum

Think about the gluten-eczema link
As you have been told by these families, gluten has been found to be an important trigger for eczema in these children.

My research findings show that the majority of people over three years of age, who have ongoing and troublesome eczema, have gluten-sensitivity. When gluten is removed from their diets, they get better.

Advice about blood testing for gluten and for information on a gluten-free diet can be found on our webpage: http://www.DrRodneyFord.com and in the previous chapters.

This is an excerpt from Dr Rodney Ford's eBook, "Dermatitis Eczema: Gluten Wheat – Solving the eczema puzzle" Available at: http://www.GlutenEczema.com

Written in the spirit of cooperation and knowledge sharing.

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