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Found 24 results

  1. Celiac and a bodybuilder. Need gluten-free BCAAs/aminos and preworkout. Certified gluten-free. Anyone have suggestions?
  2. Celiac.com 03/03/2017 - Previous studies have shown us that men are generally less troubled living with celiac disease than are women, but most studies of men with celiac disease have been mostly quantitative, and have a bio-medical emphasis. A team of researchers recently set out to explore the social experience of young men with screening-detected celiac disease and to highlight daily life situations five years after diagnosis. The research team included Ethel Kautto, Cecilia Olsson, Anneli Ivarsson, Phil Lyon, Agneta Hörnell, and Lena Alex. They are variously affiliated with the Department of Food and Nutrition and Umeå Center for Gender Studies, Umeå University, Sweden, the Department of Food and Nutrition, Umeå University, Sweden, the Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Sweden, the School of Arts, Social Sciences and Management at Queen Margaret University, UK, and the Department of Nursing at Umeå University in Sweden. Using a large Swedish school-based celiac screening-study, the team arranged to interview seven young men, all of whom were diagnosed with celiac disease at 13 years-old. The semi-structured interviews were analyzed from a gender perspective which resulted in three themes. Those themes were of young adult men being subjected to changes, striving for normality and emphasizing commitment. Many of young men reported dissociating themselves from being seen as a person with a life-long chronic disease. The analysis also showed that the young men’s daily experiences of living with celiac disease largely depended on their use of characteristics known to be associated with masculinity: such as being self-assured, demanding, and behaving authoritatively. In food situations, where the young men had the ability to make use of such characteristics in their informal group, they experienced fewer negative aspects of the disease. If the young men did not hold a strong position in their informal group, their situation was insecure and vulnerable and this could lead to avoidance of contacts and social meal situations. So, basically, being relaxed and socially confident about eating gluten-free helps to ensure success with the diet. Source: International Journal of Celiac Disease Vol. 4, No. 4, 2016, pp 138-145. doi: 10.12691/ijcd-4-4-7
  3. Celiac.com 11/14/2016 - Diagnosis of celiac disease is often delayed, sometimes into adulthood, but researchers don't have much good data on the possible consequences of such a delay. There's plenty of data to show that pediatric patients with celiac disease are often short in stature. However, there's very little data on physical features, including height, of adult patients with celiac disease. A team of researchers recently set out to evaluate whether patients suffering from celiac disease are shorter in comparison with the general population without celiac disease. The research team included Abbas Esmaeilzadeh, Azita Ganji, Ladan Goshayeshi, Kamran Ghafarzadegan, Mehdi Afzal Aghayee, Homan Mosanen Mozafari, Hassan Saadatniya, Abdolrasol Hayatbakhsh, and Vahid Ghavami Ghanbarabadi. The team also assessed likely correlations between demographic and physical features, main complains, serum anti tTG level, and intestinal pathology damage between short versus tall stature celiac patients. They conducted a retrospective cross-sectional study on 219 adult patients diagnosed with celiac disease in the Celiac Disease Center, between June 2008 and June 2014 in Mashhad, Iran. All patients were between 18 and 60 years of age. The team compared the height of the study subjects against a group of 657 age- and sex-matched control cases from the healthy population. They then then compared the likely influencing factors on height such as intestinal pathology, serum level of anti-tissue transglutaminase (anti-tTG), serum vitamin D, and hemoglobin level at the time of diagnosis in short versus tall stature patients with celiac disease. All 65 male and 154 female celiac patients were shorter than their counterparts in the general population "(males: 168.5±8.6 to 171.3±7.2 cm, p less than 0.01 and females: 154.8±10.58 to 157.8±7.2 cm, p less than 0.01). Spearman linear correlation showed height in patient with celiac disease was correlated with serum hemoglobin (p less than 0.001, r=0.285) and bone mineral density (p less than 0.001) and not with serum vitamin D levels (p =0.024, r=0.237), but was not correlated with anti-tTG serum levels (p=0.97)." Celiac patients with upper and lower quartile of height in men and women had no significant difference in the anti-tTG level and degree of duodenal pathology (Marsh grade). Shorter patients more commonly experienced anemia than taller patients. Adults with celiac disease are definitely shorter compared with healthy adults. There is a direct correlation between height and anemia and bone mineral density. This study really drives home the importance of early detection and treatment of celiac disease. Source: Middle East Journal of Digestive Diseases (MEJDD) 2016. 8(4):303-309.
  4. Celiac.com 08/08/2016 - Celiac-associated duodenal dysbiosis has not yet been clearly defined, and the mechanisms by which celiac-associated dysbiosis could concur to celiac disease development or exacerbation are unknown. To clarify the situation, a research team recently analyzed the duodenal microbiome of celiac patients. The research team included V D'Argenio, G Casaburi, V Precone, C Pagliuca, R Colicchio, D Sarnataro, V Discepolo, SM Kim, I Russo, G Del Vecchio Blanco, DS Horner, M Chiara, G Pesole, P Salvatore, G Monteleone, C Ciacci, GJ Caporaso, B Jabrì, F Salvatore, and L Sacchetti. They are variously affiliated with CEINGE-Biotecnologie Avanzate, Naples, Italy, the Department of Molecular Medicine and Medical Biotechnologies and the Department of Medical Translational Sciences and European Laboratory for the Investigation of Food Induced Diseases at the University of Naples Federico II, Naples, Italy, the Department of Medicine and the University of Chicago Celiac Disease Center, University of Chicago, Chicago, Illinois, USA, the Department of Medicine and Surgery, University of Salerno, Salerno, Italy, the Department of System Medicine, University of Rome Tor Vergata, Rome, Italy, the Department of Biosciences, University of Milan, Milan, Italy, the Institute of Biomembranes and Bioenergetics, National Research Council, Bari, Italy, the Department of Biochemistry and Molecular Biology, University of Bari A. Moro, Bari, Italy, the Northern Arizona University, Flagstaff, Arizona, USA, the IRCCS-Fondazione SDN, Naples, Italy. The team used DNA sequencing of 16S ribosomal RNA libraries to assess duodenal biopsy samples from 20 adult patients with active celiac disease, 6 celiac disease patients on a gluten-free diet, and 15 control subjects. They cultured, isolated and identified bacterial species by mass spectrometry. Isolated bacterial species were used to infect CaCo-2 cells, and to stimulate normal duodenal explants and cultured human and murine dendritic cells (DCs). They used immunofluorescence and ELISA to assess inflammatory markers and cytokines. Their findings showed that proteobacteria was the most abundant, and Firmicutes and Actinobacteria the least abundant, phyla in patients with active celiac disease. In patients with active celiac disease, bacteria of the Neisseria genus (Betaproteobacteria class) were substantially more abundant than it was in either of the other groups (P=0.03), with Neisseria flavescens being most prominent Neisseria species. Whole-genome sequencing of celiac disease-associated Neisseria flavescens and control-Nf showed genetic diversity of the iron acquisition systems, and of some hemoglobin-related genes. Neisseria flavescens was able to escape the lysosomal compartment in CaCo-2 cells and to induce an inflammatory response in DCs and in ex-vivo mucosal explants. Marked dysbiosis and the pronounced presence of a peculiar strain characterize the duodenal microbiome in active celiac disease patients. This suggests that celiac-associated Neisseria flavescens could contribute to the many inflammatory signals in celiac disease. Source: Am J Gastroenterol. 2016 Jun;111(6):879-90. doi: 10.1038/ajg.2016.95. Epub 2016 Apr 5.
  5. Celiac.com 09/15/2014 - Duodenal intraepithelial lymphocytosis (D-IEL) is an early marker for celiac disease, even though a majority of cases are due to non-celiac disease conditions. Researchers I. Aziz, T. Key, J.G. Goodwin, and D.S. Sanders wanted to identify the predictors of celiac disease in patients presenting with D-IEL. For their study, they reviewed 215 adults with D-IEL who had undergone prospective and systematic evaluation for celiac disease and other recognized associations. They confirmed celiac disease based on presence of HLA-DQ2 and/or DQ8, persistence or progression of D-IEL following a gluten challenge, and an improvement in symptoms with a gluten-free diet. To compare factors in celiac and non-celiac cases, and to determine their sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), the team used binary logistic regression models, adjusted for age and sex. They diagnosed celiac disease in 48 cases (22%) and non-celiac in 167 cases (78%). They found no statistical difference between the celiac and non-celiac group in terms of baseline demographics, anemia, hematinics, or clinical symptoms, such as diarrhea, weight loss, abdominal pain. Compared with their non-celiac counterparts, celiac patients were significantly more likely to have a positive family history of celiac disease (21% vs. 3.6%, OR 6.73; PPV 62.5%, NPV 81%, specificity 96.4%), positive HLA-DQ status (100% vs. 49.1%; PPV 36.4%, NPV 100%, specificity 50.9%), and presence of endomysial antibody (EMA) (48% vs. 0%; PPV 100%, NPV 87%, specificity 100%); all P≤0.001. A total of 29.2% celiac and 83.2% non-celiac cases showed normal tissue transglutaminase antibody (TTG) levels (OR 0.084, P<0.001; PPV 9.2%). Between the groups, there was no difference in the prevalence of TTG levels 1 to 2×upper limit of normal (29.2% celiac vs. 14.4% non-celiac; PPV 33% to 38%). However, TTG levels between 3 and 20×ULN were much more common in the celiac group (33.3% vs. 2.4%, PPV 66.6% to 89%), whereas a TTG>20×ULN was exclusive to celiac disease (8.3%, P<0.001, PPV 100%). For patients with D-IEL, only a positive EMA or TTG greater than 20×ULN at the outset can yield an immediate celiac diagnosis. On their own, factors such as gastrointestinal symptoms, family history, anemia, or other celiac serology results do not reliably distinguish celiac from non-celiac patients. Source: J Clin Gastroenterol. 2014 Jul 10.
  6. Celiac.com 11/22/2009 - Celiac disease has been associated with numerous other auto-immune disorders. Recently, there appeared the case of a 40-yr-old competitive strongman with celiac disease, who responded to a gluten-free diet, but developed profound and generalized motor weakness with acetylcholine receptor antibody positive myasthenia gravis, a disorder reported to occur in about 1 in 5000 people. A team of researchers set out to further explore this possible relationship between myasthenia gravis and celiac disease via serological study. The research team was made up of Hugh J Freeman, Helen R Gillett, Peter M Gillett, Joel Oger of the Department of Medicine (Gastroenterology and Neurology) at Canada's University of British Columbia. The researchers performed celiac disease screens on frozen stored serum samples from 23 acetylcholine receptor antibody positive myasthenia gravis patients with no intestinal symptoms. They examined both endomysial and tissue transglutaminase antibodies. One in 23 samples (or, about 4.3%) tested positive for both IgA-endomysial and IgA tissue transglutaminase antibodies. Subsequent endoscopic study showed duodenal mucosal scalloping, while biopsies confirmed the histopathological changes of celiac disease. From this, they concluded that celiac disease and myasthenia gravis may occur together more often than is currently understood. Muscle weakness in celiac disease may be a sign of possible occult myasthenia gravis, even in the absence of intestinal symptoms. Source: World J Gastroenterol 2009 October 14; 15(38): 4741-4744
  7. Celiac.com 10/23/2013 - Celiac disease remains seriously under diagnosed in adults and, in many places, often takes years and even decades to diagnose. A team of researchers recently evaluated the usefulness of an on-site rapid fingertip whole blood point-of-care test (POCT) that would help primary workers to spot patients who might benefit from further diagnostic tests for celiac disease. The research team included Alina Popp, Mariana Jinga, Ciprian Jurcut, Vasile Balaban, Catalina Bardas, Kaija Laurila, Florina Vasilescu, Adina Ene, Ioana Anca and Markku Mäki. They are affiliated with the University of Medicine and Pharmacy “Carol Davila,” the Institute for Mother and Child Care “Alfred Rusescu,” Central University Emergency Military Hospital “Dr. Carol Davila,” Str. Mircea Vulcanescu, in Bucharest, Romania and with theTampere Center for Child Health Research, University of Tampere and Tampere University Hospital, in Tampere, Finland. Because celiac disease often runs in families, the team tested 148 healthy relatives of 70 Romanian index cases with biopsy-proven celiac disease, for a total of 87% of all first-degree family members, with a median age 36 years, for the presence of circulating autoantibodies. In addition to using the POCT to measures blood erythrocyte self-TG2-autoantibody complexes on site, the team took blood samples for later evaluation of serum IgA-class endomysial antibodies (EMA). The then tested all EMA-positive samples for transglutaminase 2 antibodies (TG2-IgA). They conducted blind analysis of all serological parameters in a centralized laboratory with no knowledge of the on site POCT result. The team recommended endoscopic small intestinal biopsies for all POCT- or EMA-test positive subjects. Overall, 12 of 148 (8%) first-degree relatives showed positive results for the POCT, and all twelve tested serum EMA-positive. Only one other test subject showed a positive EMA test result. All remaining 135 healthy first-degree relatives showed negative results for both POCT and EMA. Four subjects who tested positive for both POCT and EMA were negative for TG2-IgA. Ten out of thirteen of the antibody-positive subjects consented to endoscopy. In all, eight out of nine first-degree relatives with celiac-type mucosal lesions of grade Marsh 2 (n = 3) or Marsh 3 (n = 6) showed positive results with the POCT. The three POCT-positive subjects refused endoscopy tested positive for both EMA and TG2-IgA. The fingertip whole blood rapid POCT could be a simple and cheap way to spot biomarkers and promote further testing for faster diagnosis of celiac disease. The team is calling for further studies in adult case-finding in specialized outpatient clinics and in primary care. Source: BMC Gastroenterology 2013, 13:115. doi:10.1186/1471-230X-13-115
  8. Celiac.com 09/02/2013 - Most people with celiac disease are now diagnosed as adults, and many suffer from impaired bone mineralization. Researchers A.J Lucendo and A. García-Manzanares recently conducted a review of bone mineral density in patients with adult celiac disease. Their goal was to provide an updated discussion on the relationship between low bone mineral density (BMD), osteopenia and osteoporosis, and celiac disease. They conducted a search of relevant articles published in PubMed over the last 15 years. They also reviewed all sources cited in the article results to identify potential sources of information. They found that up to 75% of celiac patients can suffer from low BMD, which can occur at any age, independently of positive serological markers and presence of digestive symptoms. Patients with osteoporotic issues have significantly higher rates of celiac disease. The team proffers two theories which may explain the origins of low BMD in celiac patients. The first says that low BMD may result from malabsorption of micronutrients (including calcium and vitamin D) determined by villous atrophy, which has has been related to secondary hyperparathyroidism and incapacity to achieve the potential bone mass peak; The second theory says that low BMD may result from chronic inflammation, which was also related with RANKL secretion, osteoclasts activation and increased bone resorption. Whatever the cause of the low BMD, people with celiac disease have more than 40% higher rates of bone fractures compared to matched non-celiac individuals. Treatment of low BMD in celiac disease includes gluten-free diet, supplementation of calcium and vitamin D, and the use of biphosphonates, the effects of which on celiac disease have not been specifically studied. Up to 75% of people with celiac disease, and 40% of those diagnosed in adulthood show low BMD, along with increased risk of bone fractures. This information shows the potential importance of bone density scans for adults with celiac disease. Source: Rev Esp Enferm Dig. 2013 May;105(3):154-162.
  9. Celiac.com 08/23/2013 - Previous studies have noted the presence of dental enamel defects in people with celiac disease. A team of researchers recently set out to study the prevalence of dental enamel defects in adults with celiac disease, and to determine if there is in fact a connection between the grade of teeth lesion and clinical parameters present at the time of diagnosis of celiac disease. The research team included L.Trotta, F. Biagi, P.I. Bianchi, A. Marchese, C. Vattiato, D. Balduzzi, V. Collesano, and G.R. Corazza. They are affiliated with the Coeliac Centre/First Department of Internal Medicine at the Fondazione IRCCS Policlinico San Matteo at the University of Pavia in Italy. The team looked at 54 celiac disease patients who had undergone dental examination. The patients included 41 females and 13 males, with an average age of 37±13 years, and with an average age of 31±14years at the time of diagnosis. Symptoms leading to diagnosis were diarrhea/weight loss (32 pts.), anaemia (19 pts.), familiarity (3 pts.). None of the patients was diagnosed because of enamel defects. At the time of evaluation, all of the patients were following a gluten-free diet. The team classified enamel defects from grade 0 to 4 according to severity. They found dental enamel defects in 46 of the 54 patients (85.2%). They found grade 1 defects in 18 patients (33.3%), grade 2 defects in 16 patients (29.6%), grade 3 defects in 8 patients (14.8%), and grade 4 defects in 4 patients (7.4%). They also observed that grades 3 and 4 were more common in patients diagnosed with classical rather than non-classical coeliac disease (10/32 vs. 2/20). However, this was not statistically significant. From this study, the team concludes that enamel defects are common in adult celiac disease, and that the observation of enamel defects offers a way to diagnose celiac disease. Source: Eur J Intern Med. 2013 Apr 6. pii: S0953-6205(13)00091-5. doi: 10.1016/j.ejim.2013.03.007. [Epub ahead of print]
  10. Celiac.com 08/19/2013 - Data from blood studies suggest that about 1% or so of North Americans have celiac disease. However, there is no good screening data based on small intestinal biopsy performed during routine endoscopic evaluations. Researcher H.J Freeman recently set out to determine rates of detection of adult celiac disease via duodenal screening biopsies over a thirty year period. For his study, he looked at patients referred between January 1982 and December 2011 for evaluation of gastrointestinal symptoms that required elective investigative upper endoscopic assessment, and who underwent duodenal biopsies to determine whether changes of adult celiac disease were present. Freeman looked at a total of 9665 patients, including 4008 (41.5%) males and 5657 (68.5%) females, who underwent elective endoscopies and duodenal biopsies. Overall, 234 patients (2.4%) exhibited changes of celiac disease. That included 73 males (1.8%) and 161 females (2.8%). During the first 20 years, the number of biopsy-positive patients in five-year intervals progressively decreased, while, during the next 10 years, the number progressively increased. From this study, the team concludes that celiac disease is far more common in specialist practice than has been suggested in the evaluation of healthy populations using serological screening studies. Endoscopic duodenal biopsy is an important way to spot underlying celiac disease and should be routinely considered in all patients undergoing an elective endoscopic evaluation. They also note that the appearance of biopsy-defined celiac disease may be influenced by non-inherited factors, possibly environmental, which alter its detection over time. Source: Can J Gastroenterol. 2013 Jul;27(7):405-8.
  11. Celiac.com 07/12/2012 - A research team affiliated with the Department of Endocrinology and Nutrition at Complejo Hospitalario Mancha Centro in Alcázar de San Juan, Spain, recently set out to study how bone mineral density correlates with duodenal Marsh stage in newly diagnosed adult celiac patients. The team made up of A. García-Manzanares, J.M. Tenias, and A.J. Lucendo. For their study, the researchers wanted to estimate the rates of low bone mineral density (BMD) in adult celiac patients and to better understand nutritional and metabolic factors associated with osteoporosis and osteopenia. To do so, they recruited patients a consecutive group of 40 adults (36 females/4 males), between the ages of 18 and 68, who were newly diagnosed with celiac disease. Average patient age was 44.25 years. For each patient, the researchers conducted bone density scans on the left hip and lumbar spine using dual-energy X-ray absorptiometry. They also assessed nutritional parameters and conducted a hormone study to exclude secondary low BMD. Overall, at diagnosis 45% of patients showed low BMD at both hip and lumbar spine. Risk of hip fracture was generally low, but climbed into the mild range for patients with villous atrophy (p = 0.011). The team also found that major fracture risk varied according to Marsh stage (p = 0.015). They found significant differences in nutritional status between patients with and without duodenal villous atrophy. Marsh III stage patients showed substantially reduced body mass index and blood levels of pre-albumin, iron, vitamin D and folic acid. The team found no differences found in blood hormone levels between Marsh stages or BMDs. They found that the amount of bone mass loss in the lumbar spine was directly tied to Marsh stage. They found a parallel association between BMD and Marsh stage in the hip, but this was not statistically significant. Overall, results showed that duodenal villous atrophy, through malabsorption, was the main factor for low BMD in patients with adult-onset celiac disease. Source: Scand J Gastroenterol. 2012 May 16.
  12. Celiac.com 09/15/2010 - Until the present study, no clinical research had been published regarding the relative effects of clinical and psychosocial variables on outcome in celiac disease. A team of researchers examined psychosocial factors that may influence disease activity in celiac patients, such as relationships among demographics, psychosocial factors, and disease activity with health-related quality of life (HRQOL), health care utilization, and symptoms. The research team included Spencer D. Dorn, Lincoln Hernandez, Maria T. Minaya, Carolyn B. Morris, Yuming Hu, Suzanne Lewis, Jane Leserman, Shrikant I. Bangdiwala, Peter H. R. Green and Douglas A. Drossman of the Center for Functional GI and Motility Disorders at the University of North Carolina, Chapel Hill, USA. The team enrolled 101 adult patients with celiac disease with the goal of charting any relationships among demographics, psychosocial factors, and disease activity with health-related quality of life (HRQOL), health care utilization, and symptoms. All patients were newly referred to a tertiary care center with biopsy-proven celiac disease. The team examined: (a) demographic factors and diet status; ( disease measures (Marsh score, tissue transglutaminase antibody (tTG) level, weight change and additional blood studies); and © Psychosocial status (psychological distress, life stress, abuse history, and coping). They then conducted multivariate analyses to predict HRQOL, daily function, self-reported health, number of physician visits, and GI symptoms, such as pain and diarrhea. They found that patients with psychological distress and poor coping skills suffered from impaired HRQOL and daily function. Patients who reported poorer health generally showed poorer coping, longer symptom duration, lower education, and greater weight loss. Patients with poorer coping, abnormal tTG levels, and milder Marsh classification generally had more physician visits. Patients with higher psychological distress and greater weight loss also showed higher pain scores. Patients with greater psychological distress and poorer coping also showed higher rates of diarrhea. Their results show that among patients at celiac disease referral centers, psychosocial factors have a greater impact on health status and GI symptoms than does disease activity. Such factors should be considered as part of the patient's treatment and prognosis. Source: Dig Dis Sci. 2010 Jul 30. DOI: 10.1007/s10620-010-1342-y
  13. Celiac.com 09/03/2010 - Many patients who show up at hospitals and clinics with non-specific gastrointestinal symptoms have rotavirus infection A team of researchers recently studied a large cohort of adults with non-specific gastrointestinal complaints to see if people with celiac disease had any higher for rotavirus. The research team included Mohammad Rostami-Nejad, BS, Kamran Rostami, MD,PhD, Maryam Sanaei, MSc, Seyed R. Mohebbi, PhD, David Al-Dulaimi, MD, Ehsan Nazemalhosseini-Mojarad, MSc, Pekka Collin, MD, Chris J. Mulder, MD, PhD, Mohammad R. Zali, MD, FACG. They are associated variously with the Research Center of Gastroenterology and Liver Diseases at Shaheed Beheshti University in Tehran, Iran; the School of Medicine of the University of Birmingham, UK, the Department of Gastroenterology at Alexander Hospital in Redditch, UK; the Department of Gastroenterology and Alimentary Tract Surgery at Tampere University Hospital in Finland, and with the Department of Gastroenterology at VU University Medical Center in Amsterdam, The Netherlands. The team conducted the study at the Research Center of Gastroentrology and Liver Disease at Taleghani Hospital in Tehran, Iran. For their study, they randomly selected 5176 individuals living in Tehran, Iran between September 2006 and September 2007. Using a questionnaire, they found 670 case of GI symptoms, each of whom was invited for additional study, including stool sampling and blood tests. The researchers screened stool samples for rotavirus using amplification of specific gene (VP6), light microscopy and formalin-ether concentration methods. They also tested subjects for celiac disease including anti-transglutaminase (tTG) antibodies and total immunoglobulin A (IgA). The research team found the VP6 gene in 150 (22.3%) individuals. 22 subjects showed positive results for anti-tissue transglutaminase (tTG-IgA) (95% CI 2.3-5.1), while three patients who were IgA deficient tested positive for the IgGtTG antibody. Eight of 25 patients (32%) showed amplification of VP6 gene, and positive blood screens for celiac disease, while 142 of 645 with negative celiac blood tests (22%) showed amplification of VP6 gene. They found no statistically important difference between the two groups (p=0.2). Unlike earlier studies in children, this adult study shows that rates of active rotavirus infection were about the same for adults who tested positive for tTG antibody as they were for adults who tested negative for tTG antibody. Based on this study, there is no higher rotavirus risk for adults with celiac disease. Source: Saudi Med J 2010; Vol. 31 (8):891-4.
  14. 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. 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: Dig Dis Sci. DOI 10.1007/s10620-010-1261-y
  15. Celiac.com 03/12/2010 - A team of researchers recently noted similar presentations of celiac disease in both elder and younger patients.The research team included Rupa Mukherjee, Ikenna Egbuna, Pardeep Brar, Lincoln Hernandez, Donald J. McMahon, Elizabeth J. Shane, Govind Bhagat, and Peter H. R. Green. They are affiliated variously with the Division of Digestive and Liver Diseases, the Division of Endocrinology, Department of Medicine, and the Department of Pathology at the Columbia University College of Physicians and Surgeons in New York, and with Columbia University Medical Center's Celiac Disease Center. It is well known that celiac disease can affect individuals of all ages. However, there have been few studies to focus solely on how celiac disease presents among elderly people. To get a better understanding of how celiac disease presents in the elderly, a research team recently set out to compare aspects of celiac disease from elderly populations with a population of young adults with celiac disease. The first step was to assemble two groups of patients, an elderly cohort over 65-years old, and a young adult cohort aged 18–30 years, with biopsy-confirmed celiac disease. They did this by reviewing a tertiary center database of celiac disease patients with celiac disease, which provided data on symptom duration, clinical presentation, small intestinal pathology, associated conditions, and the presence of bone disease. The team reviewed data on 149 young adult and 125 elderly patients with celiac disease; The elderly subjects comprised 12.4% of the patient database. Both groups showed similar duration of symptoms before diagnosis, with young adults at 5.8 ± 12 years and elderly at 6.14 ± 12.6 years, respectively (p = 0.119). The presenting symptoms were also basically the same for both groups, with diarrhea being the main presenting symptom in 49% of young adults and 50% of the elderly (p = 0.921). Both groups showed similar rates of autoimmune disease, with 19% of young adult and 26% of elderly patients having relevant autoimmune conditions (p = 0.133). Both groups showed similar presence of villous atrophy and rates of bone disease, while the elderly group showed higher rates of thyroid disease and neuropathy (p = 0.037 and p = 0.023, respectively). The team expressed surprise that, both clinically and histologically, celiac disease seems to present similarly in elderly and young adult patients. They note that since the exact causes for celiac disease at any given age remain unclear and warrant further study. Source: Dig Dis Sci DOI 10.1007/s10620-010-1142-4.
  16. Celiac.com 06/18/2009 - According to the results of a recent study, complete recovery of intestinal mucosa occurs very rarely in patients with celiac disease, despite adherence to a gluten-free diet. Generally, when people with celiac disease go on a gluten-free diet, they can expect to enjoy some healing of small intestinal mucosa. However, new data casts doubt over how much of this benefit is experienced in adult celiac patients. In order to analyze the factors that influence histological outcome of a gluten-free diet in a large cohort of adult celiac patients, a team of researchers reviewed data on 465 consecutive celiac patients studied before and during the gluten-free diet. The team was made up of A. Lanzini, F. Lanzarotto, V. Villanacci, A. Mora, S. Bertolazzi, D. Turini, G. Carella, A. Malagoli, G. Ferrante, B.M. Cesana, and C. Ricci. The researchers made duodenal biopsies of subjects at diagnosis, and classified results. They found 11 cases of Marsh I, 25 cases of Marsh II, and 429 cases of Marsh III. After an average of 16 months on a gluten-free diet, 38 patients (8%) showed histological ‘normalization’, 300 patients (65%) showed ‘remission’ with persistent intraepithelial lymphocytosis, 121 patients (26%) remained unchanged, while 6 patients (1%) showed ‘deterioration’.* Celiac disease-related blood tests were negative in 83% of patients with Marsh III lesion during the gluten-free diet. Researchers independently associated male gender and adherence to a gluten-free diet with histological ‘normalization’ and ‘remission’. There seemed to be no association between persistence of intraepithelial lymphocytosis and human lymphocyte antigen gene dose, or with Helicobacter pylori infection. From these results, the research team concluded that complete normalization of duodenal lesions is exceptionally rare in cases of adult celiac disease despite adherence to a gluten-free diet, disappearance of symptoms, and negative blood tests for celiac disease. Aliment Pharmacol Ther 29, 1299–1308 *Author's note: Could such deterioration be due to undetected exposure to gluten over time?
  17. Celiac.com 08/11/2009 - While the use of anti-tTG antibodies is common practice in the diagnosis of celiac disease, their value in long-term follow-up remains controversial. A team of researchers recently set out to assess the value of anti-tTG antibodies in long-term follow-up. The research team was made up of C.R. Dipper, S. Maitra, R. Thomas, C.A. Lamb, A.P.C. McLean-Tooke, R. Ward, D. Smith, G. Spickett, and J.C. Mansfield. Their goal was to see if they could use serial anti-tTG antibody levels to gauge adherence to a gluten-free diet (GFD) and to spot patients facing complications from celiac disease. Researchers conducted a cohort follow-up study of 182 adult subjects over 54-months. The team charted patient self-assessment of gluten-free diet adherence; anti-tTG antibody concentration and serum ferritin, vitamin B12 and folate. When possible, they measured bone mineral density (BMD) and duodenal histology. The team found that patients with persistently high anti-tTG antibody levels commonly showed abnormal duodenal histology (P < 0.001), low ferritin (P < 0.01) and poor adherence to the GFD (P < 0.001). Anti-tTG antibody specificity was > 85% while the sensitivity was 39–60%. Anti-tTG antibody concentrations fell rapidly following successful implementation of a gluten-free diet, and remained normal in those who faithfully followed the gluten-free diet. From these results, the team advocates the use of anti-tTG antibody concentrations to monitor newly diagnosed and established patients with celiac disease, and to target dietary intervention accordingly to reduce the risk of long-term problems. Alimentary Pharmacology & Therapeutics. 2009;30(3):236-244.
  18. Source: Scandinavian Journal of Gastroenterology, 18:(2):299-304, 1983 Mar. Authors - Hallert C., Astrom J., Walan A. Signs of mental depression are typical in adults with coeliac disease. The response to treatment was evaluated in 12 consecutive patients by means of the Minnesota Multiphasic Personality Inventory (MMPI), with surgical patients serving as controls. The coeliacs reported no change in depressive symptoms after 1 years gluten withdrawal despite evidence of improvement in the small intestine. When re-tested after 3 years, however, after 6 months of 80mg/day of oral pyridoxine (vitamin B6) therapy, they showed a fall in the score of scale 2 (depression) from 70 to 56 (p less than 0.01), which became normalized like other pretreatment abnormalities in the MMPI. Cholecycstectomy in the control subjects produced no alterations in the MMPI profile. The results indicate a causal relationship between adult coeliac disease and concomitant depressive symptoms which seems to implicate metabolic effects from pyridoxine deficiency influencing central mechanisms regulating mood.
  19. Celiac.com 09/13/2008 - Men who are diagnosed with celiac disease in adulthood tend to be shorter than those diagnosed and treated in childhood. A team of Israeli researchers led by Dr. Batia Weiss and colleagues recently set out to compare the adult height of people with celiac disease who were diagnosed and treated as children, against the height of those diagnosed as adults. The researchers analyzed the height of 290 patients—83 men and 207 women. Patients were grouped according to age at diagnosis. The 113 patients of group 1 were diagnosed before age 18 years, while the 177 patients of group 2 were diagnosed after age 18 years. The average adult height was 178.4 cm for men of group 1, and 176.3 cm for men of group 2, (p = 0.22). The height Z scores for men were 0.22 for group 1 and -0.08 for group 2 (p = 0.022). Researchers noted a significant inverse relationship between the age of the men at celiac disease diagnosis and their final adult height. For women, average adult height was 163.0 cm for group 1 and 162.6 cm for group 2, (p = 0.68). Height Z scores were -0.05 for the women of group 1 and -0.11 for the women of group 2 (p = 0.68). Researchers noted no significant relationship between age at diagnosis and final height in women. The exact reasons for these gender-related height differences remain unknown. They may have to do with variations in timing and duration of growth in puberty, the increased nutritional demands of adolescent men, or gender-related hormonal differences. Regardless of the exact reasons for these results, this study is just the latest of many to drive home the importance of early detection and treatment of celiac disease for everyone. American Journal of Gastroenterology 2008; 103:1770-1774.
  20. European Journal of Clinical Nutrition (2003) 57, 163-169. doi:10.1038/sj.ejcn.1601525 S Størsrud1,a,b, M Olsson2,b, R Arvidsson Lenner1,b, L Ã… Nilsson3,b, O Nilsson4,b and A Kilander2,b 1) Department of Clinical Nutrition, Sahlgrenska University Hospital, Gothenburg, Sweden 2) Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden 3) Department of Medical Microbiology and Immunology, Sahlgrenska University Hospital, Gothenburg, Sweden 4) Department of Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden Abstract: Celiac.com 3/14/2003 - Objective: The aim of the present study was to investigate whether adult patients with coeliac disease in remission could include large amounts of oats in their daily gluten-free diet for an extended period of time without adverse effects. Design, subjects and methods: Twenty adult coeliac patients in remission included large amounts of uncontaminated rolled oats in their daily diet for a prolonged period. The examinations, performed four times during the study period, included small bowel endoscopy with biopsies, blood samples (nutritional status, serological analysis), height and body weight, gastrointestinal symptoms and dietary records. Gastrointestinal symptoms and diet were also investigated through unannounced telephone interviews once a month during the study period. Results: No adverse effects of a large intake of oats were seen in small bowel histology, serology nor in nutritional status in the 15 subjects who completed the whole study period. Two of the subjects dropped out because of gastrointestinal symptoms and three for non-medical reasons. The median intake of oats was 93 g/day and the compliance to the oat diet was found to be good. Examinations of the patients after drop-out did not show any deterioration in small bowel histology or nutritional status nor raised levels of antibodies. Conclusion: Results from this study indicate that adult patients with coeliac disease in remission can include large amounts of controlled wheat-free rolled oats for an extended period of time without adverse effects. Sponsorship: This study was supported by Vårdalstiftelsen, Kommunalförbundet Västra Götaland, Stiftelsen Cerealia FoU, and the Swedish Nutrition Foundation. Kungsörnen AB supported the study with rolled oats.
  21. Eur J Gastroenterol Hepatol. 2003 Sep;15(9):995-1000. Celiac.com 08/27/2004 - Past studies have demonstrated an association, but not a causal connection, between cigarette smoking and celiac disease. Using the Bradford Hill criteria British researchers have now established a causal connection. In a matched case-control study, the researchers utilized a questionnaire to obtain the smoking histories of 138 celiacs and 276 age-matched and sex-matched controls. The subjects were then categorized according to their pre-diagnosis cigarette exposure, and it was found that 10% of celiacs, and 30% of the controls were smokers during this time. A biological gradient was demonstrated for total, recent and current cigarette exposure, and the greatest risk reduction related to current exposure. The researchers conclude: "This study strengthens the case for a causal relationship between smoking and coeliac disease by demonstrating a strong, temporally appropriate and dose-dependent effect, thus meeting the Bradford Hill criteria. This suggests that cigarette smoking truly protects against the development of adult coeliac disease."
  22. Celiac.com 11/24/2002 - The following is a Medline abstract on a study conducted by Italian researchers that demonstrated a connection between celiac disease and clinical depression. Scand J Gastroenterol 1998 Mar;33(3):247-50 Related Articles, Links Ciacci C, Iavarone A, Mazzacca G, De Rosa A. Dept. of Gastroenterology, University of Naples Federico II, Italy. BACKGROUND: Psychic symptoms and depression have been reported in celiac disease (celiac disease). The aim of this study was to explore depression in a large cohort of adult celiac disease patients. METHODS: Depressive symptoms were evaluated in 92 adult celiacs, 100 normal controls (NC), and 48 chronic persistent hepatitis (CPH) patients by means of a modified version of the Zung Self-Rating Depression Scale (M-SDS). celiac disease patients were evaluated for the level of knowledge about celiac disease and the compliance with diet. RESULTS: The M-SDS score differentiated celiac disease patients from NC. Age at diagnosis and duration of and compliance with diet did not correlate with depression. Three main factors could be identified with the M-SDS: reactiveness, pessimism, and anhedonic-asthenic. CONCLUSION: Depressive symptoms are a feature of celiac disease; they are present to a similar extent in patients with childhood- and adulthood-diagnosed celiac disease. The results underline the relevance of personal psychological resources, which play a fundamental role in determining and sustaining depression.
  23. Author: Hagander B; Berg NO; Brandt L; Nord en A; Sj olund K; Stenstam M. Source: Lancet, 1977 Aug 6, 2:8032, 270-2. In an attempt to determine the frequency of liver injury in adult coeliac disease (A.C.D.) the case records of 74 consecutive patients were examined. In 13 cases histological sections of the liver were available and in 5 of these there were signs of reactive hepatitis. Histological signs of distinct hepatic injury with cirrhosis and/or chronic active hepatitis were found in 7 other patients. In 5 of these serum-IgA was normal, whereas 16 out of 20 control patients with liver cirrhosis not associated with A.C.D. had raised serum-IgA. Serum-aspartate-aminotransferase and serum-alanine-aminotransferase were determined in 53 patients; 29 had raised concentrations. In 19 patients serum-aminotransferases were repeatedly determined before and during the dietary regimen and there was a significant reduction in enzyme concentrations during treatment. The median concentration of serum-alkaline-phosphatase was also reduced during treatment but not significantly. The histological evidence of liver injury in 16% and the abnormal liver-function tests in 39% of the patients indicate that hepatic injury is common in A.C.D. Since liver-function tests or liver biopsy specimens were available for only about two-thirds of the patients, liver damage in A.C.D. may be more common than indicated by these results. The effect of a gluten-free diet on aminotransferase concentrations indicates that the liver injury may be reversible and suggests that in some A.C.D. patients, progressive liver damage may be prevented by suitable treatment. Since A.C.D. is not always recognized, the diagnosis should be considered in patients with liver disease of unknown aetiology.
  24. Author: Bardella MT; Fraquelli M; Quatrini M; Molteni N; Bianchi P; Conte D Address: Cattedra di Gastroenterologia, Universit a degli Studi di Milano, IRCCS Ospedale Maggiore, Italy. Source: Hepatology, 1995 Sep, 22:3, 833-6 The prevalence of hypertransaminasemia and the effect of gluten-free diet (GFD) were evaluated in 158 consecutive adult celiac patients, 127 women and 31 men, aged 18 to 68 years (mean, 32). At diagnosis, 67 patients (42%) had raised aspartate and/or alanine transaminase levels (AST and ALT; mean, 47 IU/L, range, 30 to 190; and 61 IU/L, range, 25 to 470, respectively), whereas 91 patients had normal liver function tests (LFT). Patients with and without hypertransaminasemia were comparable for epidemiological data, body mass index (18.5 vs. 19.6), and severity of intestinal histological involvement. All patients were given a strict GFD and were followed for 1 to 10 years (median, 4). At 1 year, a highly significant improvement in intestinal histology was observed in both groups.
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