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Found 7 results

  1. Celiac.com 05/24/2018 - England is facing some hard questions about gluten-free food prescriptions for people with celiac disease. Under England’s National Health Plan, people with celiac disease are eligible for gluten-free foods as part of their medical treatment. The latest research shows that prescription practice for gluten-free foods varies widely, and often seems independent of medical factors. This news has put those prescribing practices under scrutiny. "Gluten free prescribing is clearly in a state of flux at the moment, with an apparent rapid reduction in prescribing nationally," say the researchers. Their data analysis revealed that after a steady increase in prescriptions between 1998 and 2010, the prescription rate for gluten free foods has both fallen, and become more variable, in recent years. Not only is there tremendous variation in gluten free prescribing, say the researchers, “this variation appears to exist largely without good reason…” Worse still, the research showed that those living in the most deprived areas of the country are the least likely to be prescribed gluten-free products, possibly due to a lower rate of celiac diagnosis in disadvantaged groups, say the researchers. But following a public consultation, the government decided earlier this year to restrict the range of gluten free products rather than banning them outright. As research data pile up and gluten-free food becomes cheaper and more ubiquitous, look for more changes to England’s gluten-free prescription program to follow. Read more about this research in the online journal BMJ Open.
  2. Celiac.com 06/29/2017 - A team of researchers recently set out to document trends in diagnosis of celiac disease among patients from a single centre from 1958–2014, and and to provide data on rates and numbers of cases in those born in Derby city over 4 decades. The team also sought to explore a possible connection between deprivation and prevalence and characteristics of celiac disease in Asians. The research team included Geoffrey K T Holmes, and A Muirhead. They are affiliated with the Royal Derby Hospital, Derby, UK, and the Department of Public Health, Derby City Council, Derby, UK. The team used National Census information to identify 2,410 adult celiac patients diagnosed in Derby area hospitals. To measure changes in disease rates and individual cases over the study period, the team identified 1,077 patients born within Derby city; 191 of whom were Asian. From 2010–2014, 20 times more patients were diagnosed than during 1975–1979. More than one-quarter of patients (27%) were diagnosed at or above 60 years of age. The team noted a low number of diagnoses in young men. They noted also that most women were diagnosed 35 and 45 years of age, which is 15 years earlier than men. Young women and elderly patients saw the largest increase in diagnosis rates. In 2014, overall prevalence was 1:188. Prevalence in women was 1:138. Nearly 5 percent of the variation was attributed to deprivation. Diagnosis rates in Asians increased markedly, although only 5 percent were diagnosed at 60 years or older, far lower than for whites. The research team calls for more research into the dramatic increase in celiac cases, and the challenges this increase presents for follow-up and new models of care need. They encourage healthcare workers to be alert to the possibility of undiagnosed celiac disease in young men and elderly Asians. They note that a dedicated celiac clinic is helpful for increasing rates of celiac diagnosis. Source: BMJ Open Gastro 2017; 4:e00013. doi:10.1136/bmjgast-2017-000137
  3. Celiac.com 01/25/2017 - The UK's Food Standards Agency (FSA) has initiated a public comment period on gluten-free labeling in England. The FSA is inviting industry feedback on the proposed Gluten In Food (Information for Consumers) (England) Regulations 2017. This regulation enforces the new European Union regulation (Commission Implementing Regulation (EU) No. 828/2014), which standardizes labeling information on products that are gluten-free or very low in gluten. The law does not require any change in formulation, ingredients or the methods for these products, but does mandate new wording for product labels. It also clarifies for consumers the difference between foods naturally free of gluten, and those specially formulated for people with gluten intolerance. The proposed rule applies to England only, not Wales, Scotland or Northern Ireland. The rule change is, in part at least, a response to rising numbers of product complaints. According to the FSA, approximately 1% of the UK population (around 600,000 people) suffers from celiac disease, while nearly half a million people remain undiagnosed. Currently, food businesses are permitted to make voluntary gluten-free or low in gluten claims, but this has led to inconsistency and confusion in many cases. Such confusion could cause health problems for those who are gluten-intolerant. Many of these products also fetch a premium price because of their gluten-free claims, stated the FSA. The aim of the English regulation is to standardize the permitted claims about gluten. Manufacturers will be limited to the use of the words "gluten-free" or "very low gluten" along with clear and limited supporting information. No other claims or descriptions are allowed, and products that fail to conform to labeling standards can be fined. The previously accepted phrase "No gluten containing ingredients (NGCI)" can no longer be used on product labels. Enforcement of FSA rules will take effect February 20, 2018.
  4. Collagenous Sprue is a distinctive lesion of the intestinal mucosa associated with progressive malabsorption. The intestinal pathology is initially identified with the characteristic flat lesion of untreated Celiac Sprue. Thereafter, bands of eosinophilic hyaline material within the lamina propria become increasingly apparent. As the disease progresses, the mucosa becomes progressively thinner. Therapy, including the gluten-free diet, does not help. Some cases currently designated refractory or unclassified Sprue many prove to be Collagenous Sprue.
  5. Celiac.com 03/19/2002 - The following excerpts were taken from The New England Journal of Medicines January 17, 2002 (Vol. 346, No. 30) article on recovery from celiac disease: In addition to a gluten-free diet, all patients with newly diagnosed celiac sprue who have clinically evident malabsorption should initially receive a multi-vitamin preparation and appropriate supplements to correct any iron or folate deficiency. Patients with steatorrhea, hypocalcemia, or osteopenic bone disease should receive oral calcium and vitamin D supplementation. Approximately 70 percent of patients have symptomatic improvement within two weeks after starting a gluten-free diet. The speed and eventual degree of histologic improvement are unpredictable but invariably lag behind the clinical response and may not be evident on repeated biopsy for two to three months. Although a return to normal histologic findings is common in children, half of adults have only a partial resolution on biopsy. If a patient has no response to the diet, the most common cause is incomplete adherence. Persistent symptoms may be caused by coexisting disorders such as irritable bowel syndrome, lactose intolerance, microscopic colitis, or pancreatic insufficiency. In one study strict adherence to a gluten-free diet reduced the risk of all disease-associated cancers including enteropathy-associated T-cell lymphoma. Thus, it seems prudent to recommend lifelong strict adherence to a gluten-free diet in all patients with celiac sprue. Regarding untreated celiac sprue: Dairy products should be avoided initially because patients with untreated celiac sprue often have secondary lactase deficiency. After three to six months of treatment, diary products can be reintroduced if the patient has no ill effects.
  6. In volume 334, number 13 of the New England Journal of Medicine was published a follow-up article concerning additional research which seems to contradict their October 19, 1995 (Vol. 333, No. 16) article which stated that pure oats are safe for celiacs. David Branski, M.D., Margot Shine, M.D., and Shaare Zedek Medical Center, Jerusalem 91031, Israel report their belief that allowing oats in the diet is premature. They sited the short duration of the study and the increased risk of cancer related through small intake of gluten (Holmes et al). It does appear that the initial study is being continued for an additional five years.
  7. New England Journal of Medicine October 19, 1995 -- Volume 333, Number 16 Celiac.com 10/25/1995 - According to an article published for the week of October 19, 1995 (Vol. 333, No. 16) in the New England Journal of Medicine, it is not a problem for celiacs to eat oats (non-contaminated, of course!). The article is based on a study conducted in Finland by a group of doctors who did very rigorous testing on adult celiacs and concluded that oats can, and should be included on the celiac diet (The lead doctor for the study is also a celiac). The following is a summary of the study: 52 celiacs in remission (on a gluten-free diet for more than a year) were given duodenal-biopsies, and then fed an average of 49.9 grams of oats per day for six months. They were again given biopsies, and none of the subjects were found to have any villi damage. There was also a group of 40 newly diagnosed celiacs who underwent the same procedures, except they were studied for 12 months rather than 6. The initial biopsies with this group showed significant villi damage due to the fact that they were still on a gluten-containing diet until they began the study. This group was fed an average of 46.6 grams of oats per day, and were given biopsies at 26 and 52 weeks. Their biopsies were almost normal at 26 weeks, which means their damaged villi were able to heal while eating oats daily. At the end of the year their biopsies showed no damage to their villi. The study DID NOT test people who had severe cases of celiac disease, and therefore cannot make recommendations with regard to them. Also, three people with dermatitis herpetiformis withdrew from the study because of an increase of itching, but none of them showed any signs of dermatitis. One person withdrew because of abdominal symptoms, but they did not exhibit damaged villi. Their conclusion: Our data suggest that most patients with celiac disease, whether in remission or newly diagnosed, can add moderate amounts of oats to their otherwise gluten-free diets without any harmful subjective side effects or laboratory abnormalities. Furthermore, among the newly diagnosed patients the improvement of mucosal architecture and the disappearance of mononuclear-cell infiltration were similar, regardless of the use of oats. -NEJM There is also an editorial from England which cites positive research which has been done there regarding oats. The NEJM is the Bible of medical research, with extensive peer reviews before publication.