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Very few celiacs are likely to have any reaction to topical gluten contact. In order for a gut reaction to occur, it is likely that direct contact with the gut lumen is required. Many people with celiac disease have everyday contact with gluten (for instance, bakers with celiac disease who have contact everyday with wheat flour), and do not have any reaction to it. However, there are, on rare occasion, people who have had an anaphylactoid response to gluten, and these people should avoid gluten in all forms. Also, topical gluten breathed into the upper airways may cause symptoms of allergic rhetinitis in rare instances. If there is a simple alternative to a shampoo, cosmetic, etc., you may want to use the non gluten containing product.
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Will Other Foods Affect the Villi? - by Kemp Randolph
Scott Adams posted an article in Allergy vs. Intolerance
The following is a March 11, 1998 post by Kemp Randolph krand@PIPELINE.COM. According to Dr. Hugh Sampson, Mt. Sinai Medical Center, at an AMA sponsored press briefing on Nutrition, in a list of Facts vs. Fictions, Fiction: Skin tests or blood tests can be used to diagnose food sensitivities. Fact: ...A positive test does not mean a person will react to a food...furthermore these tests do not tell whether a person has a non-IgE mediated sensitivity to food. He describes these tests only as useful guides and points out that diet testing is the only reliable way to identify a food allergy, preferably where the person does not know whether they have eaten the suspect food. Q: If I am sensitive to milk and eggs...could they damage my villi in the same way as gluten? A: Theres a specific note in Michael Marshs book about food allergies causing villi damage. Thats the book On Coeliac Disease, page 155. Table there shows that the Type 3 stage of intestinal response, flat destructive does occur with milk, egg, soy and chicken or fish allergies. It differs from the celiac response in that only 1 or 3 of the 5 stages of lesion connected with celiac disease occur with an allergy. Whats unclear from this reference and from Medline searches Ive made is whether food allergies in adults cause villi damage. All the references I found were for children. Villi destruction does occur in children with milk allergy, but this like other pediatric allergies, apparently is usually outgrown. -
Celiac.com 08/27/2012 - Because so many patients are now overweight upon diagnosis for celiac disease, and so fee present as classically underweight, doctors are revising the clinical presentation guidelines for celiac disease diagnosis. That being said, some researchers have voiced concern that some patients might gain further weight while on a gluten-free diet. Recently, a team of researchers conducted a study to assess the impact of a gluten-free diet on body mass index (BMI) in a nationwide group of celiac patients and to isolate any variables that might help to predict favorable or unfavorable BMI changes. The research team included Anniina Ukkola, Markku Mäki, Kalle Kurppa, Pekka Collin, Heini Huhtala, Leila Kekkonen, and Katri Kaukinen. They are affiliated variously with the School of Medicine, University of Tampere, and the Department of Gastroenterology and Alimentary Tract Surgery at Tampere University Hospital, both in Tampere, Finland. To assess weight and disease-related issues, the researchers looked at 698 newly detected adults who were diagnosed with celiac disease by classical or extra-intestinal symptoms or by screening. The researchers measured BMI upon celiac diagnosis and after one year on a gluten-free diet. They then compared the results against data for the general population. Study data showed that 4% of patients were underweight at celiac diagnosis, 57% were normal weight, 28% were overweight and 11% were obese. On a gluten-free diet, 69% of underweight patients gained weight, while 18% of overweight and 42% of obese patients lost weight. BMI remained stable for the other patients. Both symptom- and screen-detected celiac patients showed similar results. The patients with celiac disease showed a more favorable BMI pattern than the general population. The most favorable BMI changes were seen in patients with self-rated gluten-free diet expertise, along with those who were younger upon diagnosis. Dietary counseling did not seem to impact . The initial method of detection does not seem to matter for people with celiac disease who are following a gluten-free diet. Both screen-detected and symptom-detected celiac disease patients who followed a gluten-free diet showed similar improvements in body mass index (BMI). Source: Open Original Shared Link
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Celiac.com 03/15/2011 - For celiacs, it's not really the cinnamon bun that's the enemy. Nor the pizza crust, nor the ravioli. It's the gliadin in these foods - the alcohol-soluble portion of the gluten protein - that's the real culprit. Gliadin is the "gladiator" of the human digestive tract. When we ingest gliadin, enzymes try to break it down into a form that can be absorbed by the small intestine. But gliadin resists, fighting hard to remain intact. A regular small intestine has, like any good fortress, a protective wall: the mucosal lining of the intestine. This layer of mucus normally acts as a barrier against gliadin's assaults. But in a celiac intestine, the mucosal lining is permeable. With gliadin's destructive power enhanced by its enzyme sidekick, tissue Transglutaminase (tTG), it quickly gets past this poorly-guarded layer. Scientists are working to put their finger on exactly what makes the mucosal lining of a celiac's small intestine so permeable. Now a January study by Czech researchers found at least one thing that affects the permeability of the intestinal mucosa: gut bacteria. In this study, called "Role of Intestinal Bacteria in Gliadin-Induced Changes in Intestinal Mucosa: Study in Germ-Free Rats", researchers tied off sections of rats' intestines and introduced various kinds of bacteria to each section. They wanted to measure the effect that these bacteria had on the intestinal mucus - or more specifically, on the goblet cells that produce the intestinal mucus. To ensure that the kinds of bacteria in the rats' intestines were under experimental control, the rats had been raised from birth in germ-free conditions. They found that introducing gliadin to the intestines had the effect of decreasing the mucus-producing cells, thereby eroding the intestines' protective layer. No big surprises there - gliadin is a fighter, a digestive "gladiator", after all. But when they added strains of so-called harmful bacteria, Escherichia coli (otherwise known as E coli) or Shigella, the mucus-producing cells decreased even more. The cells first secreted massive amounts of mucus, then promptly exhausted themselves and gave up. This left the intestine looking very similar to that of a person in the early stages of celiac disease, say the researchers. But the tale did indeed have a happy ending. Along came the good bacteria, Bifidobacterium bifidum (or "Biff" for short). The mucus-producing cells in the small intestine increased when Biff was present. In fact, Biff was able to partially reverse the mucus-decreasing effects of E coli and Shigella. The researchers concluded that the composition of gut bacteria has an effect on the protective mucus of the intestines: an overgrowth of bad bacteria decreases the protective layer, while the addition of good bacteria increases the protective layer. Their study may eventually lead to treatment options for human celiacs, by finding ways to protect tender intestines from the harmful effects of gliadin. Source: PLoS One. 2011 Jan 13;6(1):e16169
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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
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Am J Gastroenterol. 2005 Jan;100(1):177-85 Celiac.com 06/30/2005 – In order to determine whether celiac disease mucosal lesions may have a patchy distribution that would require more than one biopsy sample to make an accurate celiac disease diagnosis, Italian researchers closely examined the detailed biopsies taken from 112 consecutively diagnosed children. All of the children in the study had positive anti-endomysium (EMA) or anti-tissue transglutaminase (tTGA) antibodies, and each underwent an upper GI endoscopy in which 4-5 biopsies were taken from Treitz and/or distal duodenum, intermediate duodenum, proximal duodenum, and the duodenal bulb. All biopsies were then classified according to the Marsh criteria. The researchers diagnosed 110 or the 112 patients with celiac disease, and none of the biopsies taken from these children appeared normal. All those diagnosed were positive for HLA-DQ2 or DQ8 genetic markers. The researchers conclude that: “Mucosal atrophy is present in 85% of patients with celiac disease and total villous atrophy is significantly more frequent in distal duodenum or proximal jejunum. Fifty percent of patients have identical villous atrophy throughout the duodenum and no duodenal areas are histologically normal. In genetically susceptible children with positive serology, a diagnosis of celiac disease can reliably be made even if biopsies are not taken from the distal duodenum or jejunum.”
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Gastroenterology, 2005; 128: 849-855 Celiac.com 04/29/2005 – In contrast to previous studies, the findings of a study by researchers in the United Kingdom indicate that women with celiac disease do not have an increased risk of infertility. Their study compared computerized primary care data on 1,521 women with celiac disease, and, unlike past studies, compared that data with 7,732 age and practice-matched women without celiac disease. They found that fertility rates were 48.2 live births per 1,000 person-years for women without celiac disease, while those with the disease had 47.7 live births. Interestingly the researchers found that women with celiac disease had lower fertility rates when they were younger, and higher rates when they were older, compared to the non-celiac group, and the increase in fertility seen in older women with the disease was not affected by whether they were on a gluten-containing vs. gluten-free diet. The researchers noted a slightly higher risk of miscarriage and delivery by cesarean section in the group of women with celiac disease, while all other negative outcomes occurred at a level similar to that of the healthy control group. The researchers conclude that women with celiac disease have similar fertility rates to that of the normal female population, and they tend to have their babies at an older age.
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