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Celiac.com 02/08/2024 - Living with celiac disease often means navigating a complex landscape of symptoms, dietary restrictions, and the quest for an optimal quality of life. Understanding Patterns Behind Persistent Celiac Symptoms Celiac disease is not a one-size-fits-all condition. A subgroup of adults experiences persistent symptoms, both gastrointestinal and extraintestinal, the origins of which are often elusive. A team of researchers recently conducted an observational study to uncover patterns within this diverse symptom landscape and explore their connections to gluten-free diet adherence, mental health, and quality of life. The research team included Cara Dochat, Niloofar Afari, Rose-Marie Satherley, Shayna Coburn & Julia F. McBeth. They are variously affiliated with San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; the VA San Diego Healthcare System, San Diego, CA, USA; the University of California San Diego, La Jolla, CA, USA; the Department of Psychological Interventions, University of Surrey, Guildford, UK; the Children’s National Health System, Washington, DC, USA; the George Washington University School of Medicine & Health Sciences, Washington, DC, USA; and the Celiac Disease Foundation, Woodland Hills, CA, USA. The Study in Focus Their study included 523 U.S. adults with self-reported, biopsy-confirmed celiac disease. Participants voluntarily completed a set of questionnaires addressing various aspects of their condition: Celiac Symptoms Index (CSI): Capturing physical symptoms and subjective health. Celiac Dietary Adherence Test: Assessing adherence to a gluten-free diet. PROMIS-29, SF-36, and Celiac Disease Quality of Life Survey: Exploring psychiatric symptoms and quality of life. Latent profile analysis identified four distinct symptom profiles: Little to No Symptoms (37%): Individuals in this profile reported excellent subjective health and minimal symptoms. Infrequent Symptoms (33%): Experience relatively moderate symptoms with a focus on extraintestinal symptoms. Occasional Symptoms (24%): Moderate symptoms, particularly gastrointestinal, physical pain, and fair to poor subjective health. Frequent to Constant Symptoms (6%): Enduring significant symptoms and fair to poor subjective health. Beyond Symptoms: The Mental Health and Quality of Life Equation Interestingly, profiles did not significantly differ in terms of clinical characteristics, gluten-free diet adherence, or overall quality of life. However, distinctions emerged in mental health dimensions. Profiles 2 and 3 reported moderate symptomology, with Profile 2 leaning toward more extraintestinal symptoms and Profile 3 showing a dominance of gastrointestinal symptoms, physical pain, and lower subjective health. Profile 3, despite its moderate symptom burden, surprisingly reported the lowest psychiatric symptoms and the highest quality of life on standardized measures. Implications and Future Directions The study’s findings underscore the complexity of celiac disease, emphasizing that a one-size-fits-all approach may not be effective. Notably, even lower symptom burden did not always correlate with better mental health and quality of life, suggesting a need for nuanced behavioral interventions. The lack of profile differences in gluten-free diet adherence implies the necessity for additional dietary or medical assessments and interventions. As we navigate the intricate terrain of celiac disease, personalized and comprehensive care emerges as a key consideration, addressing not only symptoms but also the broader aspects of mental health and overall well-being. Read more in BMC Gastroenterology volume 24, Article number: 9 (2024)

Celiac.com 11/20/2023 - Celiac disease and osteoporosis are known to be linked due to several interrelated factors. We recently did an article on the role of celiac disease in the development of skeletal alterations in patients with osteoporosis. In addition to the connections mentioned in that article, here are some additional connections between these two conditions: Malabsorption of Nutrients: Celiac disease, particularly when untreated or undiagnosed, can lead to damage in the small intestine. This damage impairs the absorption of various essential nutrients, including calcium and vitamin D. These nutrients are crucial for maintaining healthy bones. The malabsorption of calcium and vitamin D can contribute to the development of osteoporosis. Chronic Inflammation: Celiac disease is characterized by chronic inflammation in the gut. Prolonged inflammation can have systemic effects on the body, including the promotion of bone loss and the development of osteoporosis. Secondary Hyperparathyroidism: In celiac disease, the malabsorption of calcium can lead to secondary hyperparathyroidism. This is a condition where the parathyroid glands become overactive in response to low calcium levels in the blood. Hyperparathyroidism can further contribute to bone loss. Low Body Weight: Celiac disease can lead to weight loss and a lower body mass index (BMI), which is associated with an increased risk of osteoporosis. Low body weight can result in decreased bone density, making the bones more susceptible to fractures. Gluten-Free Diet and Nutrient Restoration: Fortunately, osteoporosis associated with celiac disease can often be managed or even reversed by adopting a strict gluten-free diet. When individuals with celiac disease eliminate gluten from their diet and allow their small intestine to heal, nutrient absorption improves. This, in turn, can lead to a recovery of bone density. Supplementation: In some cases, healthcare professionals may recommend calcium and vitamin D supplementation to help restore bone health in individuals with celiac disease. These supplements can be especially beneficial during the early stages of adopting a gluten-free diet when the body is still healing. Bone Density Monitoring: Individuals with celiac disease, particularly those who are newly diagnosed or have experienced severe bone loss, may benefit from bone density testing (e.g., dual-energy X-ray absorptiometry or DXA scans). Regular monitoring can help assess bone health and guide treatment decisions. Lifestyle Factors: Besides diet, other lifestyle factors like engaging in weight-bearing exercises, quitting smoking, and moderating alcohol intake can contribute to better bone health and help mitigate the risk of osteoporosis. It's important for individuals with celiac disease and osteoporosis to work closely with healthcare professionals, such as gastroenterologists, registered dietitians, and endocrinologists, to manage their conditions effectively. By maintaining a strict gluten-free diet and addressing nutritional deficiencies, many individuals can improve their bone health and reduce the risk of osteoporosis associated with celiac disease.

Celiac.com 09/21/2023 - Gluten sensitivity is a chronic intolerance to gluten in people who have a genetic predisposition. It is thought to involve the immune system and can lead to various skin conditions. Celiac disease is one common form of gluten intolerance and can affect not only the digestive system but also the skin, endocrine system, nervous system, and blood. We know that a number of skin disorders are associated with celiac disease. Psoriasis, a chronic inflammatory skin condition, has shown improvement when individuals adopt a gluten-free diet. Specifically, palmoplantar pustulosis, a variant of psoriasis, and aphthous stomatitis, which causes recurring mouth ulcers, have responded positively to gluten elimination. Dermatitis herpetiformis, another skin disorder related to celiac disease genetically, has also seen significant improvement with a gluten-free diet. However, atopic dermatitis, another prevalent long-term skin condition, has produced inconsistent results with gluten removal. Further research is needed to draw more definitive conclusions. Hereditary angioedema has shown an association with gluten intolerance in some cases, with symptomatic benefits observed after adopting a gluten-free diet. Vitiligo and linear IgA bullous dermatosis have also shown clinical evidence of improvement with a gluten-free diet. On the contrary, rosacea, a skin condition causing facial redness, has been linked to an increased risk of developing celiac disease. The Research Team A team of researchers recently set out to examine the association between gluten intolerance and skin disorders. The research team included Vaibhav Vats, Pallavi Makineni, Sarah Hemaida, Anum Haider, Sachin Subramani, Navjot Kaur, Amna Naveed Butt, Renee Scott-Emuakpor, Mohammad Zahir, Midhun Mathew, and Javed Iqbal. They include one Physician, Istanbul Okan University, Istanbul, TUR; and are otherwise variously affiliated with the department of Internal Medicine, Smt. Kashibai Navale Medical College & General Hospital, Mumbai, IND; the department of Neurosurgery, Mayo Hospital, Lahore, Pakistan; the department of Medicine/internal medicine, Allama Iqbal Medical College, Lahore, PAK; the Department of Internal Medicine, Pennsylvania Hospital, Philadelphia, USA; the department of Medicine, Ayub Medical College, Abottabad, Pakistan, Abottabad , PAK; the department Dermatology, University of Miami Miller School of Medicine, Miami, USA; the department of Medicine, Government Medical College, Amritsar, Amritsar, IND; the department of Internal medicine, ESIC medical college and hospital, Gulbarga, IND; the department of Internal medicine, Img helping hand, Karachi, PAK; and the department of Medicine, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND. Their review highlights the potential impact of gluten intolerance on various skin conditions and the potential therapeutic benefits of a gluten-free diet for managing symptoms. However, more clinical trials and observational studies are needed to fully understand the underlying mechanisms and provide definitive dietary recommendations for these conditions. Read more in Cureus.com

Celiac.com 02/08/2023 - Arthritis is a common problem for many people with celiac disease. And patients with celiac disease get rheumatoid arthritis twice as much as non-celiacs. However, the connection between arthritis and celiac disease is not well understood. A number of studies have found connections between celiac disease and arthritis. The connections are still not well understood, but here are some of the main findings. Celiac Disease and Juvenile Idiopathic Arthritis A recent study shows that JIA is nearly three times more common among children with celiac disease than in the general population. Other studies support this finding. We also know that celiac disease can occur in JIA patients with no celiac symptoms. Celiac Disease and Rheumatoid Arthritis In adults with celiac disease, rheumatoid arthritis strikes nearly 9 per 10,000 person-years and about 5 per 10,000 person-years in matched factors over a follow-up of about nine years. Rheumatoid arthritis occurs nearly twice as often among adults with celiac disease. It's important for individuals with celiac disease to be aware of the possibility of developing rheumatoid arthritis and to inform their doctor if they have any joint symptoms. High rates of Celiac Disease Antibodies in Adult Rheumatology Patients We know that studies have shown high rates of celiac antibodies in adult rheumatology patients. A recent study showed celiac antibodies in 3% of adult rheumatology patients, which provides support for celiac screening in people with rheumatological issues might be good practice. Because of the extra risk, it is important for clinicians to watch closely for signs of arthritis in celiac patients with joint symptoms, as early arthritis detection and treatment leads to much better outcomes. Look for researchers to learn more about the connections between arthritis and celiac disease going forward. Stay tuned for more on this and other important stories about celiac disease. Read more on celiac disease and arthritis Could an Old Arthritis Drug Treat Celiac Disease and Allow Celiacs to Eat Gluten Again? Celiac Disease More Common in Patients With Juvenile Idiopathic Arthritis Celiac Disease Possible in Juvenile Idiopathic Arthritis Patients with no Celiac Symptoms