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frenchiemama

Let's Talk About Poop For A Minute.

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Reading magazines is okay to do in the bathroom though :D I think the bathroom is nice because it is one place no one seems to bother you--and you can be alone. Unless you have kids I've heard... or maybe in your case Rachel :P

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Yeah, you know how you put up with things when you're in love but at some point you start thinking, ok, that is down-right weird. I think he had a dysfunctional family so it was probably nice to hide out in the bathroom, but as an adult? Uh... time to get over it...

I have a friend in England who is opening up an internet store selling specialty bathroom items (like toilet seats, etc) and she asked me if I had any poop jokes, etc, because she has a page featuring that...

http://lootopia.co.uk/catalog/tek_quotes.php

Stephanie

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Reading magazines is okay to do in the bathroom though  :D  I think the bathroom is nice because it is one place no one seems to bother you--and you can be alone.  Unless you have kids I've heard...  or maybe in your case Rachel  :P

<{POST_SNAPBACK}>

Well I'm single for the time being...so for now I do get privacy! I guess there *are* benefits to being on my own :)

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Mucus is usually associated with a Candida overgrowth of the intestines. Candida takes advantage of our gluten-damaged insides and shifts growth forms from yeast-like to fungi-like, with mycelial extensions that work their way into and between our cells like roots, causing further damage. At this point, with a damaged small intestine, Candida becomes systemic. This is another terrible burden on our livers...

I am doing a Candida cleanse right now (just by taking caprylic acid and eating lots of garlic) and have noticed an improvement in just a week. I never was one to eat a lot of sweets; sweets feed the hungry buggers. Some people have to cut all sugars, starches, and complex carbs from their diets for weeks in order to get their Candida under control again, which is really hard to do! When we are healthy, our immune system in conjunction with the friendly bacteria in our guts keep Candida in check. However, if we are still suffering from gluten ingestion our guts are not in good shape (leaky gut syndrome), our immune systems are overworked from all the food antigens escaping the gut lumen and getting in our blood, and we are in a state of intestinal dysbiosis meaning that our friendly gut bacteria have lost the war and need reinforcements! (I am also taking a good probiotic.)

And so we see mucus (fungal mycelial "rafts") in our excrement.

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Jeeesh, we really are an obsessed bunch of poop fanatic's!! Ha ha, look at all of the replies is such a short time.

So here goes my poop related question. I always had the hard as rock pellets or tennis balls like constipation my whole life. Since I went gluten free back this past May, that was one of the first things that changed. It was soft, and formed and snake like. But along with that I have had periods of rectal bleeding. I am not talking about the kind you get from constipation and ripping your insides out trying to push one out. And I know it is not hemmorroids- had those before (ouch-right after child birth).

The first time it happened I went to wipe and tissue was full of frank blood, looked down and the toilet was full of blood. I even had blood in underwear later that day (eeeww I know-can it get any grosser?) The first time it happened it lasted 2days, then just went away. Since then it has happened 2 more times, although the blood was never as much as that first time.

So that's my story anybody similiar?

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I guess that I will add my comments to this rather strange discussion. I became completely obsessed with my poop, after trying to find out what was wrong with me, and answering the questions on the forms of the many doctors that I visited. I have gone through various color changes, but mostly diarrhea, several times a day. I also passed large amounts of mucous until I had been on the gluten-free diet for about a year. I still have days of diarreha, and it is a joke at work to stay out of my way after I eat lunch. My co-workers actually send me upstairs to a bathroom that is located far away!

My husband gives me privacy, and since we have two bathrooms he uses the other one, most of the time.

The one thing that I can't seem to improve with-is the gas! I constantly feel the rumbles and have to go to the bathroom just for that purpose. My doctor doesn't take that problem seriously. Does anyone else have this problem?

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Well ever since going gluten-free I go once a day, and it happens about 30 mins after my morning coffee, and when the need strikes, it is a very urgent one. Better go or else!

But about 1/10 days, I am constipated for the day and go later in the afternoon.

Usually the constipated days it is a more normalish stool. In the AM, when it is urgent, it tends to be loose and kind of messy.

Something else is that the messy ones require a lot of TP and that in turns irritates the skind down there and it itches all day!!! Horrible! My doc said I dont have hemmorhoids but it sure hurts down there. I have found that using water to clean up helps.

<{POST_SNAPBACK}>

Try using medicated or unmedicated baby wipes - especially good to carry with you. At home try Vaseline Intensive Care Lotion as a wipe rather than water. Very Soothing. Claire

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Wandering Hermit--

IMO--the only real 'cure' for hemmorrhoids is to get "regular." I have you tried fiber, changing your diet? I know it can be really difficult to do that...I don't mean to make it sound easy. I had constipation and hemmorrhoids for years...and now after only becoming pretty 'regular' are the hemmorrhoids/irritated skin gone. In the meantime, the good ol' prep h can help. And by the way--my grandma used to put it under her eyes to temporarily shrink wrinkles :)

PS-Talking about hemmorrhoids is really embarrasing :unsure:

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Nope---never had a problem with blood if it wasnt associated with being constipated. I was always told if you have blood in your stool, it will appear brownish----not red. Also, you should immediately consult with your doctor about this.

Hope youre feeling better soon!!!!! :)

Its great that we Celiacs can openly (well, behind a computer screen actually), discuss POOP PROBLEMS!!! After all, celiac disease is a condition affecting our POOP EXPERIENCES, so if WE cant discuss it, then who should? LOL :lol:

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Nope---never had a problem with blood if it wasnt associated with being constipated. I was always told if you have blood in your stool, it will appear brownish----not red. Also, you should immediately consult with your doctor about this.

Hope youre feeling better soon!!!!! :)

Its great that we Celiacs can openly (well, behind a computer screen actually), discuss POOP PROBLEMS!!! After all, celiac disease is a condition affecting our POOP EXPERIENCES, so if WE cant discuss it, then who should? LOL :lol:

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Jenvan,

You would be amazed how well it works (Prep H).

When I have really bad bags under my eyes, I put the Preparation H Cooling Gel on my eyes the night before and "Presto"!!!, next morning, they have gone down considerably........ I kid you not! It is a well kept secret in the modelling world - almost all models use that trick......

Karen

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Preperation H could double their market share overnight if they advertised that fact.

Fast, soothing relief and look years younger all in one application. :lol:

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Thanks mandigirl1 for your concern :) . I was beginning to feel invisible here. Anyways, the first time it happened I really freaked, but I was out of town visiting my parents and they live in a real rural area, and I was there most of the summer.

In the almost 4 months I have been gluten free that has happened to me at three various times. Crazy thing, I never bleed like that when I was on gluten and constipated practically my whole life. I just figured it was one more strange symptom of this. I had absolutely no pain or burning or itching like a fissure or hemmorroid would cause. Anyways, it has been more than a month since the last episode. I do see my family care doc. at the end of them month, and will address it with her especially if it happens again.

I was hoping it was one of those crazy symptoms after being glutened or something like that. Guess not. :huh:

Bette

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Thanks mandigirl1 for your concern :) . I was beginning to feel invisible here. Anyways, the first time it happened I really freaked, but I was out of town visiting my parents and they live in a real rural area, and I was there most of the summer......]

Whoops!! forgot to log my daughter out

Bette

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Guest Viola

I bled quite heavy one day bright red. Had it all checked out with the doctor and he said not to worry about it, as it was just a burst blood vessel. And it never happened again. So guess he was right.

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Hi all - This thread cracked me up. I truly thought I was the only person analyzing every poop :)

Here's my question -- I saw some comments about mucous and candida (sp?).

I was diagnosed w/ Ulcerative Colitis when I was 8 months preggo (by sigmoidoscopy). But I wasn't getting any better and just found out that I have Celiac. Here's my question -- can someone be misdiagnosed with Ulcerative Colitis (having the mucous) if they instead have the Candida thing?

I was just put back on a steriod called Prednisone for the UC but don't want to be taking these kinds of meds w/ bad side effects.

Can anyone tell me more about Candida? Is there a test I can have done? My GI dr's look at me like I am a freak b/c I have UC & celiac disease.

Thanks,

Maureen

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Can anyone tell me more about Candida?  Is there a test I can have done?  My GI dr's look at me like I am a freak b/c I have UC & celiac disease. 

<{POST_SNAPBACK}>

There are some tests for candida but none that are completely reliable. Candida is a yeast overgrowth in the intestines it is treated w/ antifungals, probiotics etc... If your docs are looking at you like you're a freak for having UC & celiac disease....they will likely think your crazy for sure if you mention candida! This is my experience anyway....mainstream doctors don't believe in it. You can do a google on it...theres tons of info. on Candida out there. I wouldn't worry about it too much though...if we're just talking about mucus...lots of things can cause mucus besides candida.

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One of the things I love most about this group is that I come away feelilng normal!  Sounds very familar.

<{POST_SNAPBACK}>

I haven't been actually diagnosed yet....had an attack the other week and family dr. put me on a gluten free diet...feel better, but man is it a hard diet to get used to. My follow up appt. is tomorrow- I think I'm gonna request the blood tests, even though I am better. After reading the messages posted, I feel normal, too. Been having these type of problems for several years...maybe my new doc knows something the others couldn't figure out. Anyway, about being clean....I keep the alcohol free baby wipes in each bathroom at home, and a small carrying case of them at work...very useful on the bad days. They are also cheaper than the toilet paper wipes that are being sold now. I have a question to ask- my symptoms were bloating (all the time), gas (major problem- lived on Gas X- no matter what I ate or drank), IBS symptoms (no matter if it was the same food I ate the week before with no problem)- insides sore (hurt to walk), but the last bout had these symptoms, but also my backside hurt (bad)- the doc said that I didn't have hemorrhoids, but that the mucosa lining was inflamed. Does anybody else have this symptom? <_<

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Ahhhh, living on Gas-X. I had a yard sale last weekend and was going through old porses, etc, to sell, and kept finding all these gas-x and other anti-gas pills stashed (and in some, Imodium as well!) You don't know when you're sick until when you look back sometimes...

Stephanie

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Yes, I can to relate to having the pills stashed everyplace. I found out the Gas-X contained gluten, after every doctor that I went to telling me to take those things.

Mustang-Has the doctor checked you for colitis? I passed alot of mucous before going on the gluten-free diet, but also had chronic diarreha that didn't go away. I found out that I had microscopic colitis that is much better now.

I still have the gas and bloating problem, sometimes it doesn't matter what I eat. Feel better soon!

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Does mucous always mean a bigger problem other than celiac? I've had mucous in my stool in the past, but haven't seen any in a while. Anyone know?

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Yes, I can to relate to having the pills stashed everyplace. I found out the Gas-X contained gluten, after every doctor that I went to telling me to take those things.

Mustang-Has the doctor checked you for colitis? I passed alot of mucous before going on the gluten-free diet, but also had chronic diarreha that didn't go away. I found out that I had microscopic colitis that is much better now.

I still have the gas and bloating problem, sometimes it doesn't matter what I eat. Feel better soon!

<{POST_SNAPBACK}>

The first time I had an attack, I was seeing a general surgeon to prepare for a procedure (not related to digestive issues) but was so sick, swollen, insides sore..mentioned it to him...he said it sounded like colitis (been sick for a couple of days, so he said that it would take a couple of more days to get over). After that, I began having other problems- they tested me for H. Pyloric- positive- month's round of strong antibiotics, better for a short time, then worse. Began vomiting occasionally- seemed to be bile acid...gallbladder ultrasound and function test- nothing wrong there. Put me on a pill for a while...got better. They did an endoscopy and colonoscopy- no ulcer, clear, the biopsies from the colonoscopy show no IBS/IBD. <_< This was several years ago. Take Priolosec daily- heartburn issues if don't take. My new doc is the first person to mention the Gluten Intolerance to me. If I do without any, I am better. I appreciate everyone's feedback. Thanks for the encouragement! :D

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The first time I had an attack, I was seeing a general surgeon to prepare for a procedure (not related to digestive issues) but was so sick, swollen, insides sore..mentioned it  to him...he said it sounded like colitis (been sick for a couple of days, so he said that it would take a couple of more days to get over).  After that, I began having other problems- they tested me for H. Pyloric- positive- month's round of strong antibiotics, better for a short time, then worse.  Began vomiting occasionally- seemed to be bile acid...gallbladder ultrasound and function test- nothing wrong there.  Put me on a pill for a while...got better.  They did an endoscopy and colonoscopy- no ulcer, clear, the biopsies from the colonoscopy show no IBS/IBD.  <_<  This was several years ago. During this timeframe, and the recent episode, I also had fever blisters and cold sores in my mouth.  The last episode (one where doc mentioned gluten) was the worst- my gums were red and sore in spots throughout my entire mouth.  Does anyone else do this?  Now i take Priolosec daily- heartburn issues if don't take.  My new doc is the first person to mention the Gluten Intolerance to me.  If I do without any, I am better.  I appreciate everyone's feedback.  Thanks for the encouragement! :D

<{POST_SNAPBACK}>

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Hi Everyone:

The other day I was on looking at the message board. I don't post very often but I like to read what you guys and gals are up to. The other day I got on a thread (and I can't find it now) about someone new who had glutened herself with Ezekiel bread and thought that the diet wasn't working. Further down the page was a reply from someone who has also found that gluten-free is not working for her and she suggested checking out another diet called the Specific Carbohydrate Diet. The gluten-free diet is also not working right for me as I am still not digesting food (its coming out in my poop!!). So I went to the website (www.breakingtheviciouscycle.info) to check it out. I was interested enough to buy the book and I have already started the diet. I have already tried the blood type and gluten-free with only some improvement. It sounds like alot of you on this thread are still not right in the bm department and so you may want to check this out. There is a whole chapter in the book about celiac and all the research is in the back.

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    Jefferson Adams
    Celiac.com 06/18/2018 - Celiac disease has been mainly associated with Caucasian populations in Northern Europe, and their descendants in other countries, but new scientific evidence is beginning to challenge that view. Still, the exact global prevalence of celiac disease remains unknown.  To get better data on that issue, a team of researchers recently conducted a comprehensive review and meta-analysis to get a reasonably accurate estimate the global prevalence of celiac disease. 
    The research team included P Singh, A Arora, TA Strand, DA Leffler, C Catassi, PH Green, CP Kelly, V Ahuja, and GK Makharia. They are variously affiliated with the Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lady Hardinge Medical College, New Delhi, India; Innlandet Hospital Trust, Lillehammer, Norway; Centre for International Health, University of Bergen, Bergen, Norway; Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Gastroenterology Research and Development, Takeda Pharmaceuticals Inc, Cambridge, MA; Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy; Department of Medicine, Columbia University Medical Center, New York, New York; USA Celiac Disease Center, Columbia University Medical Center, New York, New York; and the Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
    For their review, the team searched Medline, PubMed, and EMBASE for the keywords ‘celiac disease,’ ‘celiac,’ ‘tissue transglutaminase antibody,’ ‘anti-endomysium antibody,’ ‘endomysial antibody,’ and ‘prevalence’ for studies published from January 1991 through March 2016. 
    The team cross-referenced each article with the words ‘Asia,’ ‘Europe,’ ‘Africa,’ ‘South America,’ ‘North America,’ and ‘Australia.’ They defined celiac diagnosis based on European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines. The team used 96 articles of 3,843 articles in their final analysis.
    Overall global prevalence of celiac disease was 1.4% in 275,818 individuals, based on positive blood tests for anti-tissue transglutaminase and/or anti-endomysial antibodies. The pooled global prevalence of biopsy-confirmed celiac disease was 0.7% in 138,792 individuals. That means that numerous people with celiac disease potentially remain undiagnosed.
    Rates of celiac disease were 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania; the prevalence was 0.6% in female vs 0.4% males. Celiac disease was significantly more common in children than adults.
    This systematic review and meta-analysis showed celiac disease to be reported worldwide. Blood test data shows celiac disease rate of 1.4%, while biopsy data shows 0.7%. The prevalence of celiac disease varies with sex, age, and location. 
    This review demonstrates a need for more comprehensive population-based studies of celiac disease in numerous countries.  The 1.4% rate indicates that there are 91.2 million people worldwide with celiac disease, and 3.9 million are in the U.S.A.
    Source:
    Clin Gastroenterol Hepatol. 2018 Jun;16(6):823-836.e2. doi: 10.1016/j.cgh.2017.06.037.

    Jefferson Adams
    Celiac.com 06/16/2018 - Summer is the time for chips and salsa. This fresh salsa recipe relies on cabbage, yes, cabbage, as a secret ingredient. The cabbage brings a delicious flavor and helps the salsa hold together nicely for scooping with your favorite chips. The result is a fresh, tasty salsa that goes great with guacamole.
    Ingredients:
    3 cups ripe fresh tomatoes, diced 1 cup shredded green cabbage ½ cup diced yellow onion ¼ cup chopped fresh cilantro 1 jalapeno, seeded 1 Serrano pepper, seeded 2 tablespoons lemon juice 2 tablespoons red wine vinegar 2 garlic cloves, minced salt to taste black pepper, to taste Directions:
    Purée all ingredients together in a blender.
    Cover and refrigerate for at least 1 hour. 
    Adjust seasoning with salt and pepper, as desired. 
    Serve is a bowl with tortilla chips and guacamole.

    Dr. Ron Hoggan, Ed.D.
    Celiac.com 06/15/2018 - There seems to be widespread agreement in the published medical research reports that stuttering is driven by abnormalities in the brain. Sometimes these are the result of brain injuries resulting from a stroke. Other types of brain injuries can also result in stuttering. Patients with Parkinson’s disease who were treated with stimulation of the subthalamic nucleus, an area of the brain that regulates some motor functions, experienced a return or worsening of stuttering that improved when the stimulation was turned off (1). Similarly, stroke has also been reported in association with acquired stuttering (2). While there are some reports of psychological mechanisms underlying stuttering, a majority of reports seem to favor altered brain morphology and/or function as the root of stuttering (3). Reports of structural differences between the brain hemispheres that are absent in those who do not stutter are also common (4). About 5% of children stutter, beginning sometime around age 3, during the phase of speech acquisition. However, about 75% of these cases resolve without intervention, before reaching their teens (5). Some cases of aphasia, a loss of speech production or understanding, have been reported in association with damage or changes to one or more of the language centers of the brain (6). Stuttering may sometimes arise from changes or damage to these same language centers (7). Thus, many stutterers have abnormalities in the same regions of the brain similar to those seen in aphasia.
    So how, you may ask, is all this related to gluten? As a starting point, one report from the medical literature identifies a patient who developed aphasia after admission for severe diarrhea. By the time celiac disease was diagnosed, he had completely lost his faculty of speech. However, his speech and normal bowel function gradually returned after beginning a gluten free diet (8). This finding was so controversial at the time of publication (1988) that the authors chose to remain anonymous. Nonetheless, it is a valuable clue that suggests gluten as a factor in compromised speech production. At about the same time (late 1980’s) reports of connections between untreated celiac disease and seizures/epilepsy were emerging in the medical literature (9).
    With the advent of the Internet a whole new field of anecdotal information was emerging, connecting a variety of neurological symptoms to celiac disease. While many medical practitioners and researchers were casting aspersions on these assertions, a select few chose to explore such claims using scientific research designs and methods. While connections between stuttering and gluten consumption seem to have been overlooked by the medical research community, there is a rich literature on the Internet that cries out for more structured investigation of this connection. Conversely, perhaps a publication bias of the peer review process excludes work that explores this connection.
    Whatever the reason that stuttering has not been reported in the medical literature in association with gluten ingestion, a number of personal disclosures and comments suggesting a connection between gluten and stuttering can be found on the Internet. Abid Hussain, in an article about food allergy and stuttering said: “The most common food allergy prevalent in stutterers is that of gluten which has been found to aggravate the stutter” (10). Similarly, Craig Forsythe posted an article that includes five cases of self-reporting individuals who believe that their stuttering is or was connected to gluten, one of whom also experiences stuttering from foods containing yeast (11). The same site contains one report of a stutterer who has had no relief despite following a gluten free diet for 20 years (11). Another stutterer, Jay88, reports the complete disappearance of her/his stammer on a gluten free diet (12). Doubtless there are many more such anecdotes to be found on the Internet* but we have to question them, exercising more skepticism than we might when reading similar claims in a peer reviewed scientific or medical journal.
    There are many reports in such journals connecting brain and neurological ailments with gluten, so it is not much of a stretch, on that basis alone, to suspect that stuttering may be a symptom of the gluten syndrome. Rodney Ford has even characterized celiac disease as an ailment that may begin through gluten-induced neurological damage (13) and Marios Hadjivassiliou and his group of neurologists and neurological investigators have devoted considerable time and effort to research that reveals gluten as an important factor in a majority of neurological diseases of unknown origin (14) which, as I have pointed out previously, includes most neurological ailments.
    My own experience with stuttering is limited. I stuttered as a child when I became nervous, upset, or self-conscious. Although I have been gluten free for many years, I haven’t noticed any impact on my inclination to stutter when upset. I don’t know if they are related, but I have also had challenges with speaking when distressed and I have noticed a substantial improvement in this area since removing gluten from my diet. Nonetheless, I have long wondered if there is a connection between gluten consumption and stuttering. Having done the research for this article, I would now encourage stutterers to try a gluten free diet for six months to see if it will reduce or eliminate their stutter. Meanwhile, I hope that some investigator out there will research this matter, publish her findings, and start the ball rolling toward getting some definitive answers to this question.
    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

    Jefferson Adams
    Celiac.com 06/14/2018 - Refractory celiac disease type II (RCDII) is a rare complication of celiac disease that has high death rates. To diagnose RCDII, doctors identify a clonal population of phenotypically aberrant intraepithelial lymphocytes (IELs). 
    However, researchers really don’t have much data regarding the frequency and significance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. Such data could provide useful comparison information for patients with RCDII, among other things.
    To that end, a research team recently set out to try to get some information about the frequency and importance of clonal T cell receptor (TCR) gene rearrangements (TCR-GRs) in small bowel (SB) biopsies of patients without RCDII. The research team included Shafinaz Hussein, Tatyana Gindin, Stephen M Lagana, Carolina Arguelles-Grande, Suneeta Krishnareddy, Bachir Alobeid, Suzanne K Lewis, Mahesh M Mansukhani, Peter H R Green, and Govind Bhagat.
    They are variously affiliated with the Department of Pathology and Cell Biology, and the Department of Medicine at the Celiac Disease Center, New York Presbyterian Hospital/Columbia University Medical Center, New York, USA. Their team analyzed results of TCR-GR analyses performed on SB biopsies at our institution over a 3-year period, which were obtained from eight active celiac disease, 172 celiac disease on gluten-free diet, 33 RCDI, and three RCDII patients and 14 patients without celiac disease. 
    Clonal TCR-GRs are not infrequent in cases lacking features of RCDII, while PCPs are frequent in all disease phases. TCR-GR results should be assessed in conjunction with immunophenotypic, histological and clinical findings for appropriate diagnosis and classification of RCD.
    The team divided the TCR-GR patterns into clonal, polyclonal and prominent clonal peaks (PCPs), and correlated these patterns with clinical and pathological features. In all, they detected clonal TCR-GR products in biopsies from 67% of patients with RCDII, 17% of patients with RCDI and 6% of patients with gluten-free diet. They found PCPs in all disease phases, but saw no significant difference in the TCR-GR patterns between the non-RCDII disease categories (p=0.39). 
    They also noted a higher frequency of surface CD3(−) IELs in cases with clonal TCR-GR, but the PCP pattern showed no associations with any clinical or pathological feature. 
    Repeat biopsy showed that the clonal or PCP pattern persisted for up to 2 years with no evidence of RCDII. The study indicates that better understanding of clonal T cell receptor gene rearrangements may help researchers improve refractory celiac diagnosis. 
    Source:
    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023

    Jefferson Adams
    Celiac.com 06/13/2018 - There have been numerous reports that olmesartan, aka Benicar, seems to trigger sprue‐like enteropathy in many patients, but so far, studies have produced mixed results, and there really hasn’t been a rigorous study of the issue. A team of researchers recently set out to assess whether olmesartan is associated with a higher rate of enteropathy compared with other angiotensin II receptor blockers (ARBs).
    The research team included Y.‐H. Dong; Y. Jin; TN Tsacogianis; M He; PH Hsieh; and JJ Gagne. They are variously affiliated with the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School in Boston, MA, USA; the Faculty of Pharmacy, School of Pharmaceutical Science at National Yang‐Ming University in Taipei, Taiwan; and the Department of Hepato‐Gastroenterology, Chi Mei Medical Center in Tainan, Taiwan.
    To get solid data on the issue, the team conducted a cohort study among ARB initiators in 5 US claims databases covering numerous health insurers. They used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for enteropathy‐related outcomes, including celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy. In all, they found nearly two million eligible patients. 
    They then assessed those patients and compared the results for olmesartan initiators to initiators of other ARBs after propensity score (PS) matching. They found unadjusted incidence rates of 0.82, 1.41, 1.66 and 29.20 per 1,000 person‐years for celiac disease, malabsorption, concomitant diagnoses of diarrhea and weight loss, and non‐infectious enteropathy respectively. 
    After PS matching comparing olmesartan to other ARBs, hazard ratios were 1.21 (95% CI, 1.05‐1.40), 1.00 (95% CI, 0.88‐1.13), 1.22 (95% CI, 1.10‐1.36) and 1.04 (95% CI, 1.01‐1.07) for each outcome. Patients aged 65 years and older showed greater hazard ratios for celiac disease, as did patients receiving treatment for more than 1 year, and patients receiving higher cumulative olmesartan doses.
    This is the first comprehensive multi‐database study to document a higher rate of enteropathy in olmesartan initiators as compared to initiators of other ARBs, though absolute rates were low for both groups.
    Source:
    Alimentary Pharmacology & Therapeutics