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Found 16 results

  1. Celiac.com 04/10/2018 - Celiac disease is a multi-system disorder with manifestations that may result in psychiatric disorders. Does that mean that celiac disease patients are more likely to take psychotropic drugs than other gastrointestinal patients? A team of researchers recently set out to assess the prevalence of medication use to treat psychiatric disorders in celiac disease patients compared to other gastrointestinal patients. The research team included Haley M. Zylberberg, Jonas F. Ludvigsson, Peter H. R. Green, and Benjamin Lebwohl. They are variously affiliated with the Division of Digestive and Liver Diseases, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, USA; the Department of Medical Epidemiology and Biostatistics, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden; the Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA; and with the Celiac Disease Center at Columbia University in New York, NY, USA. For their cross-sectional study, the team compiled data on patients undergoing esophago-gastroduodenoscopy over 9-years at a celiac disease referral center. They then compared rates of psychotropic medication use among 1,293 celiac disease patients to a control group of 1,401 patients with abdominal pain or reflux. Average patient age was 48.4 years, nearly 70% were female, and 22.7% used some sort of psychotropic medication. Overall, the team found no difference between rates of psychotropic medication use among celiac disease patients compared to control subjects. However, they did find that people with celiac disease were more likely to use antidepressants. This was confirmed using both univariate and multivariate analysis. Psychotropic medication use was not connected with either the duration or mode of presentation of celiac disease. So, even though the data show that celiac disease patients may use more antidepressants, they use psychotropic medications at similar rates as those with other gastrointestinal diseases. From these data, the study team suggests that researchers should try to assess whether people with celiac disease suffer from mood disorders that are not treated with medications. Source: BMC Psychiatry. 2018; 18: 76. Published online 2018 Mar 27. doi:  10.1186/s12888-018-1668-0
  2. Celiac.com 03/08/2018 - A team of researchers recently set out to study delays in diagnosing patients who have biopsy-proven celiac disease with gastrointestinal complaints, compared to those without non-gastrointestinal complaints. The research team included Marco A. Paez, MD, Anna Maria Gramelspacher, MD, James Sinacore, PhD, Laura Winterfield, MD, and Mukund Venu, MD. They are variously affiliated with the Division of Gastroenterology, Department of Medicine, Howard College of Medicine, Washington, DC; the Department of Medicine, the Department of Public Health Sciences, the Division of Gastroenterology, and the Department of Medicine at Loyola University Medical Center in Maywood, Illinois. The research team first conducted a medical chart review of 687 adult patients diagnosed with celiac disease. All patients they studied had biopsy-proven celiac disease and were grouped according to presence or absence of gastrointestinal symptoms before diagnosis. The team found 101 biopsy-proven celiac patients that met their study criteria. The groups were roughly equal in size, with 52 patients showing gastrointestinal symptoms before diagnosis, and 49 with no gastrointestinal symptoms. The results for the groups were starkly different. Statistical analysis revealed an average diagnosis delay of 2.3 months for the group with gastrointestinal symptoms, while the group that showed no symptoms showed an average delay of 42 months. That’s a difference of nearly 3½ years. Nearly half of the patients with non-gastrointestinal symptoms had abnormal thyroid-stimulating hormone, as opposed to 15.5% in the gastrointestinal symptom group (P = .004). Nearly 70% of patients without gastrointestinal symptoms had anemia, compared with just 11.5% of the group with gastrointestinal symptoms. Also, nearly 70% of patients in the non-gastrointestinal symptom group showed abnormal bone density scans, compared with 41% in the gastrointestinal symptom group. The team saw no sex differences on chi-squared analysis between the 2 groups. Although there is growing awareness of celiac disease, the delay in diagnosis for patients without gastrointestinal symptoms remains prolonged, with an average delay of 3.5 years for celiac diagnosis, compared with just over two months for those with symptoms. Clearly, more needs to be done with regard to diagnosing celiac disease in patients who show no symptoms. On the upside, researchers are currently working on ways to better diagnose celiac disease via faster, more accurate tests, even in patients who have already gone gluten-free. Source: PlumX Metrics
  3. Celiac.com 06/17/2013 - To investigate the prevalence of human leukocyte antigen (HLA) DQ2/8 alleles in Southern Italians with liver and gastrointestinal (GI) diseases outside of celiac disease, a team of researchers recently looked at human leukocyte antigen DQ2/8 prevalence in non-celiac patients with gastrointestinal diseases. The research team included Daniel DiGiacomo, Antonella Santonicola, Fabiana Zingone, Edoardo Troncone, Maria Cristina Caria, Patrizia Borgheresi, Gianpaolo Parrilli, and Carolina Ciacci. They are variously affiliated with the Gastrointestinal Unit of University Federico â…¡ in Naples, Italy, the Department of Medicine, Celiac Disease Center of Columbia University in New York, in the United States, The Celiac Center of Loreto Crispi Hospital in Naples, Italy, the Celiac Center, Gastrointestinal Unit in San Giovanni di Dio e Ruggi d’Aragona Hospital at the University of Salerno, and the Department of Medicine and Surgery, Campus di Baronissi at the University of Salerno Medical School in Baronissi, Italy. The team assessed HLA DQ2/8 status in 443 patients from three ambulatory gastroenterology clinics in Southern Italy. The clinics were located at the University of Federico â…¡ and Loreto Crispi Hospital in Naples, and Ruggi D’Aragona Hospital in Salerno. The team grouped patients according disease status for pre-post transplant liver disease, esophageal/gastric organic and functional diseases, irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), along with DQ2/8 alleles, which correspond to a celiac disease genetic risk scale. They then compared allele frequencies in the test subjects with healthy Italian control subjects. Out of 443 subjects, the team found that 196 subjects (44.2%), tested positive for DQ2/8. The average age of DQ2/8 positive subjects was 56 years, and 42.6% were female. Overall, the team found that 86/188 (45.7%) patients with liver disease were HLA DQ2/8 positive, 39/73 (53.4%) with functional upper GI diseases and 19/41 (46.3%) with organic upper GI diseases were positive. Moreover, 38/105 (36.2%) patients with IBS and 14/36 (38.9%) with IBD were HLA DQ2/8 positive (P = 0.21). Additionally, people with functional upper GI diseases disorders had rates of DQ2/8 positivity that were nearly double those of healthy control subjects. Those with liver disease had rates of DQ2/8 positivity that were 1.3 percent higher than controls, though this rate is not statistically significant. People with IBS and IBD had a lower rates of DQ2/8 positivity compared to healthy controls. Compared to general population estimates, the percentage of individuals who were HLA DQ2/8 positive is higher in those with liver/upper functional GI disease and lower in IBS/IBD. Source: World J Gastroenterol 2013 April 28; 19(16): 2507-2513. ISSN 1007-9327 (print) ISSN 2219-2840 (online). doi:10.3748/wjg.v19.i16.2507
  4. Celiac.com 03/25/2013 - More and more, research is showing that celiac disease may have a variety of different clinical presentations. A team of researchers recently used data from Italy, Romania and Iran to explore rates of gastrointestinal and non-gastrointestinal symptoms in patients with celiac disease. The research team included M.J. Ehsani-Ardakani, M. Rostami Nejad, V. Villanacci, U. Volta, S. Manenti, G. Caio, P. Giovenali, G. Becheanu, M. Diculescu, S. Pellegrino, G. Magazzù, G. Casella, C. Di Bella, N. Decarli, M. Biancalani, G. Bassotti, S. Hogg-Kollars, M.R. Zali, K. Rostami. They are affiliated with the Gastroenterology and Liver Diseases Research Center at Shahid Beheshti University of Medical Sciences in Tehran, Iran. For their retrospective cross-sectional study, the team used data gathered Iran, Romania and Italy from May 2009 - May 2011. The study included only cases of celiac disease confirmed by endoscopy, small bowel biopsy and positive serology. The team collected data on gastrointestinal symptoms such as abdominal pain, diarrhea, constipation, nausea and vomiting, weight loss and flatulence, as well as additional signs and symptoms of iron deficiency anemia (IDA), osteoporosis, hypertransaminasemia, and other related abnormalities. The study included 323 women and 127 men with confirmed celiac disease. Average patient age at diagnosis was 34.2 ± 16.47. A total of 157 patients (34.9%) reported at least one gastrointestinal symptom. Most of those patients reported diarrhea (13.6%), or dyspepsia and constipation (4.0%). 168 patients (37.3%) reported non-gastrointestinal symptoms, most commonly anemia (20.7%) and osteopenia (6%). The data showed statistically significant differences between the majority of symptoms, compared with the reported clinical symptoms from different countries. The study showed that European patients commonly complained of upper abdominal disorders, such as abdominal pain and dyspepsia, while Iranian patients commonly complained of the more classic celiac symptoms of diarrhea and bloating. Anemia was the most common non-gastrointestinal complaint for both Iranian and Italian patients, but was significantly higher in Iranian patients. Source: Arch Iran Med. 2013 Feb;16(2):78-82. doi: 013162/AIM.006.
  5. Celiac.com 12/15/2011 - Until now, studies have only shown a connection between celiac disease and functional gastrointestinal disorders in adults. No solid information exists regarding children. Due to the fact that gluten-induced gut inflammation is reversible by dietary manipulation, celiac disease may offer a useful model for examining the role of inflammatory triggers in various functional gastrointestinal disorders. Gut inflammation is a well-known cause of functional and structural changes in the central nervous system. Researchers suspect that the culprit is an abnormal afferent input from the gut. Psychological factors may play a role in triggering overt symptoms. A research team recently set out to examine connections between childhood celiac disease and functional gastrointestinal disorder in children meeting Rome III criteria. The team included R. Turco, G. Boccia, E. Miele; E. Giannetti, R. Buonavolontà, P. Quitadamo, R. Auricchio, and A. Staiano. Their goal was to assess the prevalence of functional gastrointestinal disorders at one year, along with the role of psychological aspects on the development of functional gastrointestinal disorders in celiac disease children. For the study, the team enrolled a group of 36 boys and 64 girls (Total = 100 children) with celiac disease, and followed them for one year. They also assembled a control group of 56 children, 25 boys and 31 girls. The team had all children and/or their parents complete validated questionnaires for GI symptoms, depression, and anxiety. The team then compared GI symptoms at diagnosis and after 1 year of gluten-free diet. The team was able to follow up on 82 of the patients with celiac disease who followed a gluten-free diet for at least one year. Of those, 23 patients (28%) met Rome III criteria for functional gastrointestinal disorders compared with 5 of 56 (8.9%) patients from the control group (P = 0.008; χ2 = 6.8; OR: 3.97; 95% CI: 1.40–11.21). Most of those children who met Rome III criteria for functional gastrointestinal disorders after one year on a gluten-free diet complained of GI symptoms alone; 21 of 52 children (40.3%) overall. Children with celiac disease with FGDIs showed substantially higher levels of anxiety and depression compared to control subjects, and to celiac disease children without functional gastrointestinal disorders (P = 0.02). The study shows that children with celiac disease, who follow a gluten-free diet for a year, have much higher rates of functional GI symptoms than do non-celiac control subjects. The risk may be due to residual chronic inflammation, and/or to psychological factors, but further study is needed to make that determination. Source: Alimentary Pharmacology & Therapeutics. 2011;34(7):783-789.
  6. Celiac.com 02/15/2012 - At the American College of Gastroenterology (ACG) 2011 Annual Scientific Meeting held in Washington, DC, Caris Diagnostics, a leader in anatomic pathology services, presented 15 abstracts highlighting new findings that reflect and expand Caris' commitment to gastrointestinal disease research. Highlights from the presentation include two studies, in particular. The first study, "High Prevalence of Celiac Disease in Women With Young Onset Collagenous Colitis," found that young women with collagenous colitis are eight times more likely than the general population to have celiac disease. That study was authored by Ahmed Bedeir, MD, Bhaskar Ganguly, and Mukunda Ray, MD, PhD. As Dr. Bedeir's finding is gleaned from the largest series of young patients with collagenous colitis ever reported, the study team recommends that women age 40 or younger who have a diagnosis of collagenous colitis also undergo an EGD with duodenal biopsies to exclude concurrent celiac disease. The second study, "Seasonal Patterns in Eosinophilic Esophagitis: An Analysis by Month of Diagnosis and Month of Birth," showed that, contrary to previous suggestions derived from smaller series, there was no evidence of monthly or seasonal variation even within known regions with diverse climates among our 10,000 patients with eosinophilic esophagitis. That study was authored by Jennifer M. Hurrell, DO, Amnon Sonnenberg, MD, and Robert M. Genta, MD, FACG. Regarding Caris' commitment to gastrointestinal disease research, Richard H. Lash, MD, Chief Medical Officer for Caris says that the "establishment of the Caris Research Institute as a structure for promoting and carrying out research has again generated a strong presence at the annual ACG meeting in Washington, D.C," adding that Caris remains "committed to leveraging our tremendous database and academic talent to answer important questions in the field of gastroenterology and are honored to have the opportunity to present our findings at ACG 2011." Source: http://www.carislifesciences.com/news/caris-diagnostics-presents-research-at-2011-annual-meeting-of-the-american-college-of-gastroenterology/
  7. Celiac.com 01/18/2012 - A number of small studies have shown a connection between celiac disease and various gastrointestinal (GI) cancers, but the results haven't been corroborated by larger studies, or by blood and biopsy analysis of large populations. That means that researchers just haven't been able to say with certainty what the results of those smaller studies might mean about cancer risks for the larger population. Recently, a clinical team set out to assess GI cancer risks for a larger population. The study team included Peter Elfström, Fredrik Granath, Weimin Ye, and Jonas F. Ludvigsson. They assessed risk GI cancers by using data from large groups of patients with either celiac disease, inflammation, or latent celiac disease. They assessed data from 28,882 patients with celiac disease, all with villous atrophy, and Marsh scores of 3. They also assessed data for 12,680 patients with inflammation, all with Marsh scores of 1–2. They evaluated biopsy samples at 28 different pathology centers. They assessed a third group of 3705 patients with latent celiac disease, that is, with normal mucosa, but positive blood tests. The team then compared the results against data from an age- and sex-matched population. They found that 372 of the patients with celiac disease developed incident GI cancers, while 347 patients with inflammation, and 38 with latent celiac disease developed GI cancers. That means that the first year after diagnosis and initial biopsy, celiac disease carried a 5.95-times greater risk of incident GI cancer, with a 95% confidence interval [CI], 4.64–7.64). The hazard ratio for inflammation was 9.13 (95% CI, 7.19–11.6) and for latent celiac disease was 8.10 (95% CI, 4.69–14.0). After the first year, patients showed no significant increase in GI cancer risk. The HR for celiac disease was 1.07 (95% CI, 0.93–1.23), for inflammation it was 1.16 (95% CI, 0.98–1.37). HR for latent celiac disease it was 0.96 (95% CI, 0.56–1.66). The absolute risk for any GI cancer in people with celiac disease was 101/100,000 person-years, with an excess risk of 2/100,000 person-years. The results carried some relatively good news. That is, even though celiac disease, inflammation, and latent disease all increase a person's risk for GI cancers in the first year after diagnosis, there is no increase in risk beyond the first year. Source: Clinical Gastroenterology and Hepatology. Volume 10, Issue 1 , Pages 30-36, January 2012
  8. Celiac.com 11/28/2011 - Celiac disease often results in "leaky" intestinal mucosa. This development may involve changes in hydrophobicity of the mucus surface barrier along with changes of the epithelial barrier. A team of researchers recently compared bio-physical aspects of gastrointestinal mucosa of celiac patients with control subjects, along with the effects of gluten free diet on each group. The research team included Stefania Bertolazzi, Francesco Lanzarotto, Barbara Zanini, Chiara Ricci, Vincenzo Villanacci, and Alberto Lanzini. The team set out to compare duodenal hydrophobicity as an index of mucus barrier integrity in 38 patients studied before and 68 patients during gluten-free diet, and in 90 control subjects. They also checked for regional differences of hydrophobicity in the gastro-intestinal tract. The team gauged hydrophobicity by measuring the contact angle (CA) (Rame Hart 100/10 goniometer) created by a single drop of water applied to intestinal mucosal biopsies. Once the team pooled the results and evaluated the control groups, patients with histologically normal duodenal biopsies showed significantly higher CA (620 + 90) than patients with biopsies showing Marsh 1-2 (580 + 100; p<0.02) and Marsh 3 lesions (570+ 100; p<0.02). Among the control group, the action sequence of hydrofobicity along the gastrointestinal tract follows the pattern: gastric antrum> corpus> rectum> duodenum> oesophagus> ileum. From these results, the team concludes that people with celiac disease experience reduced hydrophobicity of duodenal mucous layer, and a reduced ability to repel luminal contents. This may may contribute to the increased intestinal permeability seen in celiac disease. This change in hydrofobicity corresponds to the severity of the mucosal lesions in the patient, and is not completely reversed by gluten-free diet. Source: BMC Gastroenterology 2011, 11:119 doi:10.1186/1471-230X-11-119
  9. Celiac.com 04/12/2010 - A team of researchers recently set out to look at connections between psoriasis, the liver, and the gastrointestinal tract. The team was made up of Paolo Gisondi, Micol Del Giglio, Alessandra Cozzi & Giampiero Girolomoni. They are associated with the Section of Dermatology and Venereology of the Department of Medicine, at the University of Verona, Italy. Psoriasis is a common chronic inflammatory, immune-mediated skin disease that is often tied to other disorders, including psoriatic arthropathy, chronic inflammatory bowel diseases, and cardio-metabolic disorders. Additionally, about 50% of all patients patients with psoriasis suffer from non-alcoholic fatty liver disease, from 0.2–4.3% suffer from celiac disease, and about one half of one percent suffer from Crohn's disease. These associated conditions may have some common genetic traits, as well as common inflammatory pathways, and their presence offers important implications in the global approach to treating psoriasis. In particular, common systemic antipsoriatic drugs might have a negative affect on associated cardio-metabolic conditions and nonalcoholic fatty liver disease, and may have important interactions with drugs commonly used to treat psoriasis. Moreover, the team emphasizes the importance of encouraging psoriasis patients to drastically improve their modifiable cardiovascular and liver risk factors, especially obesity, alcohol and smoking intake, because improvements could have positive impact on both the psoriasis and the patient's general well-being. Source: Dermatologic Therapy, Volume 23 Issue 2, Pages 155 - 159 - DOI: 10.1111/j.1529-8019.2010.01310.x
  10. Celiac.com 09/12/2011 - Exogenous enzymes are enzymes that are created outside of the body. Doctors use exogenous enzymes, usually orally, to treat several diseases, such as pancreatic insufficiency and lactose intolerance. Because these enzymes are protein-based, they can be inactivated and/or digested in the gastrointestinal (GI) tract. A research team recently established a convenient fluorescence-based test to measure the activity of therapeutic enzymes live and in real time in the GI tract. The research team included Gregor Fuhrmann and Jean-Christophe Leroux. They are affiliated with the Department of Chemistry and Applied Biosciences, Institute of Pharmaceutical Sciences in Zurich, Switzerland. To establish proof of their principle, the team applied their assay to proline-specific endopeptidases (PEPs), a group of enzymes recently proposed as adjuvant therapy for celiac disease, which is a very common immunogenetic enteropathy. To do so, they took a short PEP-specific peptide sequence from larger immunotoxic sequences of gluten. They then labeled each sequence with a fluorescent dye and a corresponding quencher. Once the enzyme sequence split, they dequenched the fluorescence emission and then used an live imaging system to detect the result. The team then evaluated PEPs originating from Flavobacterium meningosepticum (FM) and Myxococcus xanthus (MX) after oral administration in rats. While MX PEP could not split the peptide in the stomach, FM PEP showed significant gastric activity reaching 40–60% of the maximal live signal intensity. However, both enzymes produced similar fluorescence signals in the small intestine. Using an antacid significantly enhanced MX PEP’s gastric activity due to increased pH and/or inhibition of stomach proteases. By using this simple method, the team was able to observe differences in the live performance of PEPs, which could not be identified under laboratory conditions. This imaging method could be used for live study other oral enzymes and may prove useful in improving current treatments. Source: PNAS 108:9032-9037. DOI:10.1073/pnas.1100285108
  11. Celiac.com 07/02/2010 - Serological screening of healthy volunteers from around the world estimates that the prevalence for celiac disease is approximately 0.5%- 1% of the total population. However, a recent meta-analysis denotes that the actual ratio of known or undiagnosed celiac cases is closer to 1 in 7 people. Due to knowledge of celiac, acute clinical suspicion, and increased endoscopy accessibility some areas have reported celiac prevalence as high as 5.2%; suggesting that there is a considerable gap in effectively detecting new cases of celiac disease. Researchers further investigated the statistics on celiac disease prevalence by evaluating the incidence of celiac disease among “adult out-patients biopsied during upper endoscopy with typical and atypical symptoms”. One hundred and fifty out-patients including 94 women and 56 men with a median age of 45, were enrolled for the study between January 2007 and December 2008. There is no current standard classification for endoscopic lesions found from celiac disease. As such, this study used a method of classification where-as patients were labeled as; normal, mild, moderate, or severe. To detect villous atrophy, biopsy's were taken from patients that were only presenting endoscopic appearances, which are indicative of celiac disease. Results which had t-TGA levels greater than 24 U/mL were considered positive for celiac disease. Patients were also positively diagnosed as celiac if they exhibited some degree of histological abnormality. Of the hundred and fifty subjects studied, twelve were diagnosed positively for celiac disease, and nine of them were women. The most commonly exhibited gastrointestinal pathology diagnosed in the study, was gatroduodenitis peptic ulcer. All of the subjects that had biopsy proven t-TGA, had positive antibodies, and the values of t-TGA increased depending on the intensity of the mucosal lesions. Additionally, all subjects were assessed for the existence of gastrointestinal and extra-intestinal symptoms. Typical gastrointestinal symptoms of celiac include diarrhea, anemia and weight loss, as evident in 58.32% of the subjects studied, while atypical symptoms were present in 25% of the test subjects. 41.66% of the subjects had iron deficiency anemia(IDA), 8.33% had osteopenia, 16.66% had hypocalcaemiaia and hypomagnesaemia. Additionally, extra-intestinal symptoms associated with gastrointestinal manifestations were found in 16.66% of the subjects that had astenia, and in 41.55% of the subjects with weight loss. Almost every celiac case observed demonstrated symptoms that progressively increased in severity. No differences were observed among patients in the control group, and in the celiac patients with regard to gastrointestinal problems and discomforts. However, IDA was observed most frequently in patients with celiac disease than in the control group. All patients that were diagnosed were recommended to strictly adhere to a gluten-free diet. One person refused to comply with the diet, but the other 90% followed the diet for one year. Of the patients following a gluten-free diet, a total histological response was observed. Severity of mucosal lesions decreased in 70% of the subjects, and all subjects were asymptomatic after one year on a gluten-free diet. The final incidence of celiac disease in the study was 6%. Screening studies such as these, demonstrate that the prevalence of celiac disease is increasing. When duodenal biopsy was preformed in patients during routine upper gastrointestinal endoscopy, the incidence of celiac disease was observed at rates as high as 12%. Additionally, when clinical presentations of symptoms like diarrhea, anemia, and weight loss are used as screening criteria for celiac, increased rates of celiac disease diagnosis' were evident. Strict adherence to a completely gluten-free diet is still the only cure for celiac disease. Increased doctor and patient awareness of celiac, as well as an increase in celiac screening (especially for patients with typical celiac symptoms or atypical symptoms untreated by standard methods) is still needed to avoid more cases of undiagnosed celiac disease, and to eliminate unnecessary suffering for those misdiagnosed or undiagnosed. Source: Journal of Experimental Medical & Surgical Research, Year XVII · Nr.1/2010 · Pag.23 -27
  12. More and more people with celiac disease present atypical symptoms that are clinically indistinguishable from other gastrointestinal disorders. A new study shows that upwards of 4% of people with generalized gastrointestinal complaints show elevated celiac disease antibodies when screened. A team of researchers recently set out to assess rates of celiac disease in patients with gastrointestinal symptoms, and to catalog the common manifestations of atypical expressions of celiac disease. The research team was made up of Mohammad Rostami Nejad, Kamran Rostami, Mohamad Amin Pourhoseingholi, Ehsan Nazemalhosseini Mojarad, Manijeh Habibi, Hossein Dabiri, and Mohammad Reza Zali. The team designed and executed a cross sectional study that included 5,176 individuals chosen randomly from self-referred patients within a primary care setting in Tehran province from 2006-2007. In all, 670 of the 5176, or 13% of patients self-referred to a general practitioner suffered from gastrointestinal complaints. All 670 subjects with gastrointestinal symptoms underwent celiac blood tests, including total immunoglobulin A (IgA) and anti-tissue transglutaminase (tTG) antibodies. Individuals showing IgA deficiency underwent screening for IgG tTG. Of the 670 investigated for gastrointestinal complaints, a total of 22 patients, 17 women and 5 men, showed positive anti-tTG results (95% CI: 1.70-4.30). Another 8/670 showed IgA deficiency, with 3 of those 8 subjects showing positive IgG tTG. Dyspepsia (indigestion) was the chief complaint in 25 patients withpositive blood tests and cases that were analogous to the rest of thesubjects. In all, 3.3% of serologically screened samples excluding IgA-deficient showed celiac disease antibodies, compared to 3.7% of those IgA-deficient subjects with positive tTG-IgG. Generalized gastrointestinal complaints are a common indication of atypical celiac disease. This study points to high rates of celiac disease antibodies among patients with generalized gastrointestinal symptoms (3.7%). Clinicians and patients will benefit from greater vigilance regarding atypical presentation of celiac disease and its association with generalized gastrointestinal symptoms. Source: Journal of Gastrointestinal Liver Disease - September 2009 Vol.18 No 3, 285-291
  13. Scand J Gastroenterol 2000 Sep;35(9):947-9 Lohiniemi S, Maki M, Kaukinen K, Laippala P, Collin P. Dept. of Medicine, Tampere University Hospital, University of Tampere, Finland. SPECIAL NOTE: European Codex Alimentarius quality wheat starch was used in this study. (Celiac.com 06/25/2000) BACKGROUND: A wheat starch-based gluten-free diet is widely adopted in the treatment of coeliac disease, even though the products contain trace amounts of gluten. The aim here was to establish whether such a diet sustains abdominal symptoms. METHODS: The Gastrointestinal Symptom Rating Scale (GSRS) was applied to 58 coeliac disease patients on gluten-free diets and 110 non-coeliac controls. An estimate was made of daily dietary fiber and wheat starch-derived gluten. Psychological well-being was evaluated by a structured interview. Twenty-three coeliac patients consented to small bowel biopsy. RESULTS: The mean GSRS score in coeliac disease patients did not differ from that in control subjects. Poorer psychological well-being was associated with abdominal symptoms in coeliac patients, whereas the daily amount of wheat starch had no effect on GSRS score. Overall dietary compliance was good, and villous atrophy was found in only 2 out of 23 patients. The average fiber consumption, 13 g per day, was lower than recommended. CONCLUSIONS: Wheat starch-based gluten-free products are well-tolerated in coeliac disease patients, provided that their diets are otherwise strict.
  14. Nature Immunology 2, 353 - 360 (April 2001) Celiac.com 04/12/2001 - According to an article published in the April issue of Nature Immunology, Dr. Marc Rothenberg and colleagues at the Childrens Hospital Medical Center in Cincinnati, Ohio performed a series of experiments on mice which led them to the conclusion that white blood cells called eosinophils could be the cause of many food allergies and gastrointestinal inflammation. The researchers believe that the eosinophil cells, which are present throughout the body, mistakenly identify food proteins as germs in individuals with food allergies. When the intestinal lining of an allergic person is exposed to an allergen, a substance called eotaxin is released by the cells lining the intestine, which causes the eosinophil cells and other immune cells to attack them and release powerful proteins that destroy the surrounding tissues and cause eosinophilic inflammation. The results of this study are unique because this is the first time eosinophils cells have been implicated in causing allergies, even though scientists have known for some time that they were present in great numbers at the sites of inflammation caused by reactions to food. The implication of this study is the possible development of drugs that stop this reaction from occurring, and thus prevent digestive inflammation and destruction that occurs when people with food allergies eat foods to which they are allergic. These results put scientists one step further in understanding how and why the digestive system is attacked in certain individuals, and a possible means of one day controlling the process.
  15. Celiac.com 09/29/2003 - The results of a study published in the September edition of American Journal of Gastroenterology indicate that women with treated celiac disease suffer twice as many gastrointestinal symptoms than do their male counterparts, and that men with treated celiac disease suffered no more GI symptoms than did the normal population. More studies need to be done, however, to determine why male celiacs seem to respond better to treatment than females. Some follow-up work has already been done on this topic. -Scott Here is the abstract: Am J Gastroenterol. 2003 Sep;98(9):2023-6. High rate of gastrointestinal symptoms in celiac patients living on a gluten-free diet: controlled study. Midhagen G, Hallert C. Department of Internal Medicine, Skovde Hospital, Skovde, Sweden The aim of this study was to determine the occurrence of GI symptoms in adults with celiac disease (celiac disease) treated with a gluten-free diet for several years. We studied a cohort of adults with celiac disease (n = 51; 59% women) aged 45-64 yr and proved to be in remission after 8-12 yr of treatment. They were examined by the GI Symptom Rating Scale, which comprises five syndromes: indigestion, diarrhea, constipation, abdominal pain, and reflux. A general population sample (n = 182; 57% women) of same age served as controls. Subjects with celiac disease reported significantly more GI symptoms than the general population sample, as assessed by the GI Symptom Rating Scale total score (p
  16. New England Journal of Medicine, May 2, 1996 -- Volume 334, Number 18 Kenneth D. Fine The New England Journal of Medicine published a study in the May 2, 1996 (Volume 334, Number 18) issue regarding the prevalence of occult gastrointestinal bleeding in patients with celiac sprue. Its goals were to explain the iron deficiency found in many celiacs. The fecal samples of 8 Patients with partial villous atrophy and 28 with total villous atrophy were studied. Their results found 25% of patients with partial villous atrophy and 54% of Patients with total villous atrophy tested positive for blood. They concluded that gastrointestinal bleeding can be found in about 50% of patients with celiac sprue, and should therefore be added to the list of factors that can contribute to iron deficiency in celiacs. The following are comments on this article by Karoly Horvath, M.D., Ph.D., of Baltimore, Maryland, USA. If you have any questions you can e-mail him at: khorvath@umabnet.ab.umd.edu Date: 05/02/96 - 08:20:20 AM. Subject: Re: Fecal Occult Blood, Plus Elevated Liver Enzymes FECAL OCCULT BLOOD: The cited NEJM paper found occult intestinal bleeding in patients who had some degree (partial and total) of intestinal villous atrophy. However, this paper have certain methodological problems. The first, and most important -as you can read in the editorial comment- that they did not place the patient on a specific diet before collecting the stool. It is a rule that the patients should be on a diet which eliminate all the peroxidase containing food. So this may increase the number of false positive cases. The second problem that the hemoccult test is only a screening method, which does not give information about the degree of blood loss. The test can be positive in the presence of small amount of blood in the stool. While this paper has limitations, I should accept that patients with mucosal atrophy and inflammation have small amount of blood loss. So I do not have any doubt regarding the final conclusion of paper, that patients with active celiac disease have blood loss in the stool. This is not surprising and not a novel finding. To avoid any panic in the celiac community I do not recommend to post this finding without appropriate comment to the Celiac List. We should emphasize one sentence from this paper: ALL THE PATIENTS WITH PREVIOUSLY DIAGNOSED AND TREATED CELIAC SPRUE HAD NEGATIVE TESTS FOR FECAL OCCULT BLOOD. LIVER ENZYMES: It is well known that patient with intestinal inflammation may have elevated liver enzymes. The well known examples are patients with inflammatory bowel disease. Because patients with active celiac disease have significant accumulation of inflammatory cells in the mucosa it is not surprising that a percentage of patients with active celiac disease have elevated liver enzymes. However, this is a temporary elevation, which disappears on gluten-free diet. The explanation is not clear for this finding. The simplified explanation is that there is an increased permeability in the inflamed intestinal segments and different toxins, which normally are detoxified by the enterocyte Cytochrom P450 enzyme system, enter the portal circulation and there is an increased toxin load into the liver.
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