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Celiac.com 05/01/2023 - Celiac disease is a condition that affects millions of people worldwide. Celiac disease is an immune-mediated enteropathy triggered by gluten, a protein found in wheat and related grains. For people with celiac disease, eating gluten can lead to a range of symptoms and damage to the small intestine. The only effective treatment for the disease is a strict gluten-free diet, which allows the intestines to heal and prevents further complications. However, recent research has shed light on the potential dangers of having celiac disease: the danger of malignant complications. A group of researchers at the Department of Internal Medicine and Gastroenterology, University Hospital Brno, recently conducted a study examining the occurrence of malignancies in patients with celiac disease. They wanted to raise awareness of these potentially life-threatening complications, with the hope of promoting earlier diagnoses and better outcomes. Occurrence of Malignancies in Patients with Celiac Disease The study analyzed seven cases of malignancies that occurred among 190 celiac disease patients over a seven-year period. The patients ranged in age from 36 to 82 years old, with a mix of men and women. The malignancies found by the team included small bowel adenocarcinoma, diffuse large B-cell lymphoma, carcinoma of the tongue, and colorectal carcinoma. The overall findings were alarming, as malignancies were present in nearly 4% of the patients in the study. This highlights the need for better awareness of the potential risks associated with celiac disease. Professionals Need to Work Towards Earlier Diagnoses By understanding the risk factors, recognizing the presentation of malignant complications, and closely monitoring the disease course, healthcare professionals can work towards earlier diagnoses and better outcomes for patients. The study also emphasized the importance of continued research into potential risk factors for malignancies in celiac disease patients. Identifying these factors could help in developing strategies for prevention and early intervention. For people living with celiac disease, this research underscores the need for regular check-ups and close monitoring of their condition. It's really important for patients to maintain a strict gluten-free diet, as this remains the only real way for celiacs to stay as healthy as possible. By doing so, celiacs can reduce their risk of complications and improve their overall quality of life. Read more in Journal of Medical Case Reports

Celiac.com 9/26/2019 - Small bowel adenocarcinoma is a rare abnormal tissue growth, that can happen alone, or can also be the result of predisposing conditions, including hereditary syndromes and immune-mediated intestinal disorders, such as celiac disease. However, researchers still don't know very much about small bowel adenocarcinoma in the context of celiac disease. To get some answers, a research team recently set out to show the main clinical features, diagnostic procedures and management options of small bowel adenocarcinoma cases detected in a large cohort of celiac patients diagnosed in a single tertiary care center. The research team included Giacomo Caio, Umberto Volta, Francesco Ursini, Roberto Manfredini, and Roberto De Giorgio. They are variously affiliated with the Department of Medical Sciences, University of Ferrara, St. Anna Hospital in Ferrara, Italy; the Mucosal Immunology and Biology Research Center and Celiac Center, Massachusetts General Hospital- Harvard Medical School, Boston, MA, USA; the Department of Medical and Surgical Sciences, University of Bologna in Bologna, Italy; and the Department of Medical Sciences, University of Ferrara, St. Anna Hospital, Ferrara, Italy. The team retrospectively reviewed all small bowel adenocarcinoma cases from a group of 770 celiac disease patients of the Celiac Disease Referral Center at the University Hospital in Bologna, Italy from January 1995 to December 2014. The group included nearly 600 females, spanned 18 to 80 years of age, and averaged 36 years old at diagnosis. A total of five of the 770 celiac disease patients developed small bowel adenocarcinoma. All were female, and about 53 years old on average, though the individuals ranged from 38 to 72 years old. The small bowel adenocarcinoma was diagnosed along with the celiac disease in three cases. It was localized to the jejunum in four cases, and to the duodenum in one case. The clinical presentation of small bowel adenocarcinoma was characterized by intestinal sub-occlusion in two cases, while the main presentation in the other three cases were iron deficiency anaemia, abdominal pain and acute intestinal obstruction, respectively. All the patients underwent surgery, while three patients with advanced stage neoplasia also received chemotherapy. The overall survival rate at 5 years was 80% for the group. The observed celiac disease-related small bowel adenocarcinoma cases were marked by a younger age of onset, were mainly female, and faced better odds of survival, compared with sporadic, Crohn- and hereditary syndrome-related small bowel adenocarcinoma. Read more in BMC Gastroenterology volume 19, Article number: 45 (2019)

Celiac.com 08/10/2020 - Small bowel cancers are on the rise. Research has shown some possible connections with celiac disease, but there have not been any detailed large group studies. To better understand the connections between celiac disease and small bowel cancers, a team of researchers recently set out to conduct a large group study. The UK and Swedish based team turned to the nationwide ESPRESSO cohort study to gather data on everyone diagnosed for celiac disease from 1965 through 2017 at any of the twenty-eight pathology centers in Sweden. They defined celiac disease as duodenal or jejunal villous atrophy, with a stage 3 Marsh score, and matched celiac patients with up five control subjects randomly chosen from the general population. They used stratified Cox regression to calculate hazard ratios for small bowel adenocarcinoma, adenomas and carcinoids. Over an average follow up of 11 years, they matched nearly 50,000 celiac patients with about 240,000 controls. Overall, for about every 3,000 patients with celiac disease followed for 10 years, they found one extra case of small bowel adenocarcinoma. They observed an inverse relationship between mucosal healing and risk of future small bowel adenocarcinoma, though this was not statistically significant. Their analysis showed the absolute risk of small bowel adenocarcinoma is low in people with celiac disease. However, even though the absolute risk is low, the team found that risks are still much higher than non-celiacs for small bowel adenocarcinoma and adenomas, but not for carcinoids. The good news is that the overall risks of developing small bowel adenocarcinoma remain low in people with celiac disease. The bad news is that the risk is still many time greater than it is for people without celiac disease. Read more in Gastroenterology The research team included Louise Emilsson, Carol Semrad, Benjamin Lebwohl, Peter Hr Green, and Jonas F Ludvigsson. They are variously affiliated with the Department of General Practice & Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Faculty of Medicine and Health, Örebro University, SE 701 82, Örebro, Sweden; Vårdcentralen Årjäng and Centre for Clinical Research, County Council of Värmland, Värmland, Sweden; the University of Chicago Medicine, Chicago, IL, USA; the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; the Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA; the Department of Paediatrics at Örebro University Hospital, Örebro, Sweden; and the Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.

Celiac.com 05/20/2019 - A stuffy and obscure-sounding scientific paper has more than a few people excited about a breakthrough breath test to help manage diabetes, celiac disease and other conditions. Celiac is one of the most common and misdiagnosed disease. The process of getting a proper diagnosis can be long and convoluted. In part, that's because people with celiac disease may have few or no symptoms. In fact, these days, most people diagnosed with celiac disease report few or no symptoms. In fact, it's not at all uncommon for a person with celiac disease to suffer for up to 10 years before getting a proper celiac diagnosis. In diabetes, glucagon increases blood glucose levels. In diabetes treatment, DPP-4 inhibitors are used to reduce glucagon and blood glucose levels. According to Wikipedia, they do this by increasing levels of incretin, GLP-1 and GIP, "which inhibit glucagon release, which in turn increases insulin secretion, decreases gastric emptying, and decreases blood glucose levels." The excitement arrises because a team of scientists has developed a selective, non-invasive breath test that could be used to diagnose and treat celiac disease and Type-II diabetes. The development team set out to develop a selective, non-invasive, stable-isotope 13C-breath test that can detect dipeptidyl peptidase-4 inhibitors (DPP4i), a class of orally available, small molecule inhibitors for the management of Type-II diabetes. The team included Roger Yazbeck, Simone Jaenisch, Michelle Squire, Catherine A. Abbott, Emma Parkinson-Lawrence, Douglas A. Brooks & Ross N. Butler. The team's paper carries the very weighty title: Development of a 13C Stable Isotope Assay for Dipeptidyl Peptidase-4 Enzyme Activity A New Breath Test for Dipeptidyl Peptidase Activity. If you read that title, and understood only the words "breath test," you are not alone. The title and the paper are highly scientific. The takeaway is that the test they developed could be useful in diagnosing, treating, and managing diabetes and gastrointestinal diseases, including celiac disease. The team's paper describes in detail their development process for the stable-isotope 13C-breath test for DPP4. The test could potentially help to treat and manage diabetes, celiac disease, and other conditions, including certain cancers. "Furthermore," the paper reads "the significant pool of DPP4 in the small bowel and in inflammatory conditions suggests that a DPP4 breath test could also have potential application as a non-invasive method to measure intestinal function/integrity and immune status. Certain cancers also exhibit high expression of DPP4 as exemplified by the adenocarcinoma cell line in this study and this may provide a measure of cancer activity and response to therapy." Imagine a quick non-invasive breath test that can do all that. That's exciting stuff. Among other things, it could mean better treatment, and less unnecessary suffering. We say: Yes, please! Do you find the idea of a breath test for diabetes and celiac disease an exciting prospect? Share comments below. Read more in Nature.com Scientific Reports; volume 9, Article number: 4906 (2019. Also of interest is D Detel, M Persic, & J Varljen's paper titled "Serum and intestinal dipeptidyl peptidase IV (DPP IV/CD26) activity in children with celiac disease," and published in the Journal of Pediatric Gastroenterology and Nutrition; 45, 65–70