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Found 12 results

  1. Celiac.com 10/23/2017 - What's the relationship between celiac disease and liver histology, serology and treatment response? Celiac disease is diagnosed on the basis of ESPGHAN criteria, and clinical response to gluten-free diet. Researchers have noted histological abnormalities on liver biopsies in patients with celiac disease, but have rarely described the abnormalities in detail. A team of researchers recently set out to assess the histological spectrum of 'celiac hepatitis' and to see if a gluten-free diet can reduce such features. The research team included K Majumdar, P Sakhuja, AS Puri, K Gaur, A Haider, and R Gondal. They are variously affiliated with the Department of Pathology, and the Department of Gastroenterology at the G B Pant Institute of Postgraduate Medical Education and Research, New Delhi, India. Their team analyzed twenty-five patients with concomitant celiac disease and hepatic derangement for clinical profile, laboratory investigations and duodenal and liver biopsy. They then made a histological comparison of pre- and post-GFD duodenal and liver biopsies, where possible. They found that fifteen patients with celiac disease later developed abnormal liver function tests. They also found that 7 out of 10 patients with liver disease showed tissue positive transglutaminase, while 6 of the 10 had antigliadin antibodies. Eight patients showed serological markers for autoimmune liver disease (AILD). Liver histology ranged from mild reactive hepatitis, chronic hepatitis, and steatosis to cirrhosis. They found six patients with liver biopsies made after a gluten-free diet. Five of these patients showed a decrease in steatosis, portal and lobular inflammation and fibrosis score. From these results, they concluded that celiac hepatitis could be a distinct condition, and that patients may present with either celiac disease, or with secondary hepatic derangement. They recommend celiac evaluations for patients with AILD, unexplained transaminasaemia or anemia. This is one of the few studies to show the range of histological changes to the liver in patients with 'celiac hepatitis'. They note that the adoption of a gluten-free diet in such patients may help to improve symptoms of 'celiac hepatitis'. Source: J Clin Pathol. 2017 Sep 29. pii: jclinpath-2017-204647. doi: 10.1136/jclinpath-2017-204647.
  2. Celiac.com 09/25/2017 - There are currently several efforts underway to develop successful commercial enzyme treatments for celiac disease. Efforts include looking at the digestive enzymes in plants, such as the papaya and star fruits, including such predatory plants, such as the pitcher plant. One focus has been on developing enzymes that can break down gluten before it can trigger an immune reaction. This could prove helpful to many people with celiac disease. One such enzyme under development is Latiglutenase, formerly known as ALV003. Latiglutenase is a new name for an enzyme therapy designed to be taken with meals. The idea is that a person with celiac disease would take an enzyme tablet with a meal. If the meal had mild gluten contamination, the enzyme’s two recombinant proteins would break gluten into fragments that are not toxic to the immune system, thereby preventing exposure, and symptoms. But the stomach is a notoriously difficult environment to work in, so what seems like a simple idea quite a challenge from a science and biology perspective. Seeking to explore the ability of Latiglutinase to improve symptoms, a team of researchers recently set out to test latiglutenase on celiac patients who are seropositive despite following a gluten-free diet. The research team included Jack A. Syage, Joseph A. Murray, Peter H. R. Green and Chaitan Khosla. They are variously affiliated with the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester USA, the Celiac Disease Center at Columbia University, New York, USA, the Departments of Chemical Engineering and Chemistry, Stanford University, USA, and with ImmunogenX, Newport Beach, USA. "Though the ALV003-1221 trial was inconclusive regarding histologic improvement from latiglutenase, the evidence for symptom benefit, which is more quickly achieved, is quite convincing and clinically relevant," Joseph Murray, MD, of the Mayo Clinic in Rochester, Minn., said in a press release. In these trials, patients with celiac disease who were seropositive despite following a gluten-free diet saw major improvement in symptoms when taking latiglutenase with meals, according to a post hoc analysis of the CeliAction study. The team was really hoping to see histological improvement, but they feel satisfied that this trial shows, says Dr. Murray, that a "therapy to help patients struggling with symptoms due to celiac disease is now within reach." Stay tuned for more on efforts to develop effective enzyme treatments for celiac disease. Read more: Dig Dis Sci. 2017 Doi:10.1007/s10620-017-4687-7.
  3. Celiac.com 05/26/2017 - Can a gluten-free diet help improve symptoms in people suffering from IBS? A new study says yes, some of them, at least. More than 60% of patients with IBS suffer from bloating and abdominal pain after eating certain foods. In some patients, who do not have celiac disease or wheat allergy, these symptoms may be due to an adverse reaction to wheat and gluten. Several studies have suggested that anti-gliadin antibodies can be a useful benchmark for predicting which patients with irritable bowel syndrome will benefit from a gluten-free diet. However, the idea remained untested until recently, when researchers conducted a prospective study in IBS patients. An update on their research was presented at Digestive Disease Week. The research was conducted by María Inés Pinto Sanchez, MD, and colleagues at the department of medicine at McMaster University and the Farncombe Institute in Ontario, Canada. To better understand the usefulness of these predictors, the research team looked at 44 patients with IBS and 23 healthy volunteers, both before and after 1 month of adhering to a gluten-free diet. They assessed GI transit, GI symptoms, anxiety, depression, somatization and dietary habits. The team tested each subject for anti-gliadin antibodies, then stratified the patients based on the results. Patients with celiac disease were not included in the study. The investigators found that just over half (53%) of the IBS patients, and 25% of the healthy volunteers, tested positive for IgA or IgC anti-gliadin antibodies. Additionally, HLA DQ2/DQ8 genetic predisposition was comparable for both groups. IBS patients who tested positive for antigliadin antibodies, and who followed a gluten-free diet, showed overall improvement in symptoms, especially constipation (P = 0.01), diarrhea (P = 0.001) and abdominal pain (P < 0.001) while IBS patients who tested negative only experienced improvements in abdominal pain (P = 0.01). Compared with patients who tested negative, gluten-free IBS patients who tested positive saw more normalization in GI transit (OR = 1.75 95% CI, 1.06 - 3.06). Regardless of antibody status, all IBS patients saw comparable improvements in anxiety, somatization and well-being, but only patients who tested positive saw reduced depression scores. A gluten-free diet in patients who tested positive for anti-gliadin antibodies was associated with symptomatic improvement (OR = 8.54; 95% CI, 1.41-48.21), while other factors like changes in motility, dietary adherence or genetic risk were not. Their data led the team to conclude that anti-gliadin antibodies can be used to determine which IBS patients are more likely to see an improvement in symptoms, and in functionality. Interestingly, strict compliance with the gluten-free diet did not predict improvement, which indicates that gluten restriction, rather than gluten avoidance, may help to manage symptoms in these IBS patients. That means that patients might be able to get better by cutting back on gluten, instead of cutting it out of their diet entirely. Read more at Healio.com.
  4. Celiac.com 08/22/2016 - Many doctors hear from celiac patients who suffer from persistent symptoms despite a long-term gluten-free diet. A research team recently set out to investigate the prevalence and severity of these symptoms in patients with variable duration of a gluten-free diet. The research team included Pilvi Laurikka, Teea Salmi, Pekka Collin, Heini Huhtala, Markku Mäki, Katri Kaukinen, and Kalle Kurppa. They are variously affiliated with the School of Medicine, University of Tampere, Tampere 33014, Finland, the Department of Internal Medicine, the Department of Dermatology, the Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, University of Tampere, Tampere 33014, Finland, and the Tampere School of Health Sciences, at the University of Tampere in Tampere 33014, Finland, the Centre for Child Health Research at the University of Tampere and Tampere University Hospital, Tampere 33014, Finland. Altogether, the team classified 856 patients into three groups: 128 untreated patients, 93 on a short-term gluten-free diet of 1–2 years, and 635 patients on a long-term gluten-free diet of 3 years or longer. They conducted analyses of clinical and histological data and dietary adherence. They also included a control group of 166 healthy subjects. The team evaluated symptoms according to the validated GSRS questionnaire. They compared severity of symptoms against severity in cases of peptic ulcer, reflux disease, inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). Altogether, 93% of the short-term and 94% of the long-term treated patients had a strict gluten-free diet and recovered mucosa. Untreated patients had more diarrhea, indigestion and abdominal pain than those on a gluten-free diet and controls. Their results showed no differences in symptoms between the short- and long-term gluten-free diet groups, though both showed poorer GSRS total score than control subjects, with p = 0.03 and p = 0.05, respectively. Patients treated 1–2 years had more diarrhea (p = 0.03) and those treated >10 years had more cases of reflux (p = 0.04) than control subjects. Meanwhile, long-term treated celiac patients showed relatively mild symptoms compared with other gastrointestinal diseases. Based on these results, most celiac patients showed a good response to gluten-free diet, which continued in long-term follow-up, although not all patients see their health return to that of non-celiac individuals. Source: Nutrients 2016, 8(7), 429. doi:10.3390/nu8070429
  5. Celiac.com 03/27/2015 - Researchers don't have any solid idea about how common cases of seronegative celiac disease might be, but many feel strongly that rates of seronegative celiac disease are underestimated in children, and may result in misdiagnosis of celiac cases. One team of researchers wondered if an emphasis on "serology-led" diagnosis might be contributing to a low rate of celiac disease diagnosed in children from the United States. That research team included Deborah L. Preston and Yoram Elitsur, and they recently set out to investigate the rate of celiac disease after upper endoscopy (EGD) with no prior positive celiac serology compared with the rate of celiac disease followed by positive serology. The team conducted a retrospective review of that charts of all of the first diagnostic EGDs in children (2009–2013). They split the patients with confirmed celiac disease into 4 groups: group A, positive EGD/positive serology (histology-led diagnosis); group B, positive serology/positive histology (serology-led diagnosis); group C, positive histology followed by negative serology (control 1); and group D, positive serology followed by negative histology (control 2). The team reviewed a total of 761 upper endoscopic charts. They confirmed 15 children with celiac disease, for a rate of 1.97%. Group A and group B had similar demographic data or clinical symptoms, and similar rates of celiac disease between histology-led celiac diagnosis (group A) and serology-led celiac diagnosis (group (1.18% vs 0.79%, P = 0.273). This study showed that endoscopy-led diagnosis and serology-led diagnosis found celiac disease at similar rates. This finding suggests that better diagnosis of celiac disease in children requires performing an adequate number of intestinal biopsies in every diagnostic upper endoscopic procedure. Source: Journal of Pediatric Gastroenterology & Nutrition: March 2015 - Volume 60 - Issue 3 - p 357–359. doi: 10.1097/MPG.0000000000000602
  6. Celiac.com 04/09/2012 - Many people with celiac disease suffer from fatigue and may limit theirsocial activities, both of which can lead to a decrease in physicalactivity, and potentially lower bone mass. A team of medical researchers recently set out to study the effects of exercise and gluten-free diet on bone-mass in women with celiac disease. The research team included Valentina Passanantia, Antonella Santonicolaa, Cristina Buccia, Paolo Andreozzia, Antonella Ranaudoa, Daniel V. Di Giacomoc, and Carolina Ciacci. They are affiliated with the Department of Clinical and Experimental Medicine at the University Federico II of Naples, Italy, the Gastrointestinal Unit of Salerno University Medical School in Salerno, Italy, and the Celiac Disease Center of the Department of Medicine at Columbia University in New York. For their study, the team recruited two groups of women. In both groups, they examined physical activity, fatigue and bone mineral density in women with celiac disease, both at diagnosis and while following a gluten-free diet. In the first group of 48 women, the team measured bone mineral density at diagnosis and after 2 years of a gluten-free diet. In the second group, this one with 47 women, researchers measured bone mineral density at diagnosis, and after 5 years of a gluten-free diet. The researchers questioned and assessed both groups regarding physical activity and ranked them on a visual analogue scale regarding their perception of fatigue at diagnosis and follow-up. The team also gathered data on smoking habits, alcohol use, gastrointestinal symptoms, drug therapy and body mass index. Across the board, for all factors, the two groups showed similar results. At follow-up, the mean body mass index and physical activity questionnaire scores were similar to baseline. Both groups showed increased bone density and unchanged scores for physical activity and visual analogue scale. For both groups, bone density improved significantly after two years on a gluten-free diet. In both groups, physical activity was often low and played only a small role in changes to bone mineral density. So, exercise does not seem to help increase bone mineral density in any significant way, and following a gluten-free diet is sufficient to re-establish bone mineral density to healthy levels. Source: 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. doi:10.1016/j.dld.2011.12.012
  7. Celiac.com 07/25/2014 - People with non-celiac gluten sensitivity (NCGS) do not have celiac disease, but their symptoms improve when they are placed on gluten-free diets. A research team set out to study the specific effects of gluten after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates (fermentable, oligo-, di-, monosaccharides, and polyols [FODMAPs]) in subjects believed to have NCGS. The study team included J.R. Biesiekierski of the Department of Gastroenterology, Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia, and colleagues S.L. Peters, E.D. Newnham, O. Rosella, J.G. Muir, and P.R. Gibson. They conducted a double-blind cross-over trial on 31 women and 6 men, aged 24-61, with NCGS and irritable bowel syndrome (based on Rome III criteria), but not celiac disease. Researchers randomly assigned participants to groups given a 2-week diet of reduced FODMAPs. Participants were then placed on high-gluten (16 g gluten/d), low-gluten (2 g gluten/d and 14 g whey protein/d), or control (16 g whey protein/d) diets for 1 week, followed by a washout period of at least 2 weeks. The team measured serum and fecal markers of intestinal inflammation/injury and immune activation, and indices of fatigue. Twenty-two participants were then given either gluten (16 g/d), whey (16 g/d), or control (no additional protein) diets for 3 days. The team evaluated symptoms using visual analogue scales. Every patient experienced significant improvement in gastrointestinal symptoms during reduced FODMAP intake. Conversely, every patient experienced significantly worse symptoms when their diets included gluten or whey protein. The team observed gluten-specific effects in just 8% of participants. They saw no diet-specific changes in any biomarker. During the 3-day re-challenge, participants' symptoms increased by similar levels among groups. Gluten-specific gastrointestinal effects were not reproduced. The end result for this placebo-controlled, cross-over re-challenge study showed no evidence of specific or dose-dependent effects of gluten in patients with NCGS placed on diets low in FODMAPs. The translation is that the team saw no effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Source: Gastroenterology. 2013 Aug;145(2):320-8.e1-3. doi: 10.1053/j.gastro.2013.04.051. Epub 2013 May 4.
  8. Celiac.com 03/26/2014 - Metabolic bone disease (MBD) is one of the less recognized of the various symptoms of celiac disease, and is attributed to secondary hyperparathyroidism, which in turn is associated with increased bone remodeling. Bone mineral density (BMD) is known to improve for celiacs on a gluten free diet, but there is very little data on the efficacy of bisphosphonates in celiac disease patients. Bisphosphonates are potent inhibitors of bone resorption, and may be useful in celiac patients with low BMD. A team of researchers recently set out to assess the effect of the bisphosphonate zoledronic acid on BMD in celiac disease patients. The research team included Mukul Kumar, Ashu Rastogi, Sanjay Kumar Bhadada, Anil Bhansali, Kim Vaiphei & Rakesh Kochhar of the Departments of Endocrinology, Histopathology & Gastroenterology, Postgraduate Institute of Medical Education & Research, Chandigarh, India. The researchers recruited a total of 28 celiac disease patients, who were each randomized to receive gluten free diet, calcium and cholecalciferol (group A), and zoledronic acid (group . The team performed baseline biochemical tests and T-score by dual energy x-ray absorptiometer, and tested again after one year. They found T-score improvement in the control arm (group A) from -3.31 ± 1.46 to -2.12 ± 1.44, a gain of 35.9 per cent (P However, they found no difference in T-score improvement in zoledronic acid group as compared to the control group. Thus, administration of zoledronic acid was revealed to be no better than gluten free diet alone in increasing BMD in celiac disease patients with low BMD in this pilot study. Source: Indian J Med Res 138, December 2013, pp 882-887
  9. Celiac.com 05/08/2013 - A team of researchers recently set out to test determine if an interactive online intervention might help to improve gluten free diet adherence in adults with celiac disease. The research team included Kirby Sainsbury BA/BEd, DCP (candidate), Barbara Mullan PhD and Louise Sharpe PhD. They are affiliated with the School of Psychology, and the Clinical Psychology Unit at the University of Sydney in Sydney, New South Wales, Australia For their controlled trial, the researchers recruited 189 adults with biopsy-confirmed celiac disease. They randomly assigned 101 adults to receive the intervention, and 88 adults to a wait-list control condition. They retrieved post-intervention data for 70 intervention subjects and 64 wait-list participants, along with three month follow-up data for 46 of 50 who completed the intervention period. The team first measured overall gluten-free diet adherence, then measured gluten-free diet knowledge, quality of life and psychological symptoms. The researchers based their results on intention-to-treat analysis, which bases their calculations on initial treatment assignment and not on the treatment eventually received. ITT analysis helps avoid various misleading factors that can color intervention research, such as non-random attrition of participants from the study or crossover. Overall, the intervention group showed strong improvement in gluten-free diet adherence, and gluten-free diet knowledge following the treatment period compared to the wait-list control group. However, changes in knowledge had no effect on adherence. These improvements continued through the 3-month’ follow-up period. The results show that the online intervention program helped improve adherence to a gluten-free diet for people with celiac disease. Such a program can be developed into a valuable resource for celiacs who are struggling with gluten-free diet adherence. Source: Am J Gastroenterol advance online publication 5 March 2013;
  10. Celiac.com 02/22/2013 - Scientists estimate that about 1% of the global population has celiac disease. For those who suffer, following a gluten-free diet is the only treatment available. Among doctors such treatment is known as 'medical nutritional therapy (MNT).' Recently, researchers have paid more attention to sourdough lactic acid bacteria as a way to improve the therapeutic benefits of gluten-free bread and baked goods for people on a gluten-free diet due to celiac disease. A team of researchers recently set out to assess use of sourdough lactic acid bacteria as a cell factory for delivering functional biomolecules and food ingredients in gluten free bread. The research team included Elke K Arendt, Alice Moroni and Emanuele Zannini. They are variously affiliated with the School of Food and Nutritional Sciences at University College Cork, Western Road, and the National Food Biotechnology Centre at University College Cork, in Cork, Ireland. More and more, consumers are demanding higher quality gluten-free bread, clean labels and natural products. Still, replacing gluten in bread presents significant technological challenges due to the low baking performance of gluten free products (gluten-free). Sourdough has been used since ancient times to improve quality, nutritional properties and shelf life of traditional breads, sourdough fermentation may offer a better solution for commercial production of gluten-free breads. In a recent issue of Microbial Cell Factories, the research team highlights how sourdough lactic acid bacteria can be an efficient cell factory for delivering functional biomolecules and food ingredients to enhance the quality of gluten free bread. Source: Microbial Cell Factories 2011, 10(Suppl 1):S15. doi:10.1186/1475-2859-10-S1-S15
  11. Celiac.com 01/23/2013 - Can going gluten-free bring about a major improvement in mental health for some children? This question is addressed in recent article by Mary Lochner. In the article, Lochner talks about the challenges she faced in trying to raise her daughter who, for the first couple of years, seemed to become more and more emotionally volatile and unstable, even while her daughter's twin brother seemed just fine. Lochner details her trips to multiple pediatricians and behavioral therapists in an effort to get an answer for her daughter's behavior. Initially, the behavioral therapists pretty much dismissed her concerns and, when Lochner asked what she could do to calm her daughter down, told her to “Try distracting her…Give her a toy that makes noise. Or sit her down in front of the T.V. for a while.” Unimpressed with the advice, Lochner says she knew, as a mother often does, that something was, in fact, wrong with her child. In the mean time, her daughter's temper was becoming progressively more volatile. She began having behavioral episodes during the night, as well as during the day. The first time it happened, she woke up screaming hysterically at 2 a.m. Lochner found a new pediatrician for her daughter, one who took her concerns seriously. He ran Mary Jean through a test or screening for everything from iron deficiency to autism. At the same time, she continued to do her own research, and began to wonder if the problem might be Sensory Processing Disorder. It was during this time that Lochman stumbled onto the writings of nutritionist, Kelly Dorfman, who had co-authored an article in the Huffington Post which claimed that gluten intolerance sometimes manifests with “neurological symptoms.” The basic thrust of the article was that, for some people, gluten-sensitivity can cause neurological symptoms. While she was investigating that possibility, s came across an article from the March 2012 Huffington Post called “Is Sensory Processing Disorder the New Black?” The article described the case of a child whose extreme behavioral symptoms disappeared after her mother put her on a gluten-free diet after consulting a nutritionist. For Lochman, the article hit close to home, and led her to read Kelly Dorfman’s book concerning nutritional origins of childhood illnesses: What’s Eating Your Child? Initially, Lochman says she was skeptical of claims of major behavioral improvement in children who had gone gluten-free, and regarded much of what she'd heard about gluten-free diets with some doubt. However, she did bring up the book with her pediatrician, and, rather than dismissing her, the doctor confirmed that gluten can cause behavioral problems in some gluten-sensitive children. He suggested that her daughter go gluten-free for a month, then back on gluten for a month, then gluten-free a second month, and that she keep a journal of her daughter's behavior. By doing the gluten-free trial twice, she and the doctor would be able to confidently confirm that any improvement in my daughter’s behavior was due to the removal of gluten, and not to coincidence. During the first month on a gluten-free diet, her daughter’s episodes decreased sharply, but Lochman was still skeptical. However, when she went back to eating gluten during the second month, the emotional outbursts and episodes came back in less than a week. By the end of that second month, she found herself looking forward to returning her daughter to the gluten-free diet for month three of the trial. In the third month, her daughter’s episodes rapidly decreased during the first two weeks. By the end of the month, they were down to only two or three times a week. This is when Lochman really knew something was up. She says that she thought that her daughter was seeing a major shift, if not a miracle cure. She quick to tell people how she was wrong to think that. That's because, Lochmans says that taking gluten out of her daughter's life was, in fact, a miracle cure. She says that after just six weeks on the gluten-free diet, "her daughter's 'awful screaming and flailing episodes, the ones that would last for hours and come out of nowhere, were gone. Vanished. A thing of the past. It was like she was a completely new, and different, person." Lochman describes a daughter who now only gets upset with good reason, and who is highly responsive…a daughter who now looks her in the eyes again, who easily relaxes to snuggle, and who is ebullient, curious, affectionate, and "so thoroughly level-headed you would be hard pressed to connect her to her former self." For her part, Kelly Dorfman notes that non-celiac gluten-sensitivity has only recently been identified as a distinct medical condition, one that resists conventional tests for diagnosing celiac disease. She says that she commonly sees patients in her practice for whom behavior and mood issues are the only symptoms of gluten intolerance. Dorman's new book is due to be re-released in April under a new title, Cure Your Child With Food, and includes a new chapter with more on information on 'bizarre' gluten-related effects on behavior and more. Read Mary Lochner's full article in the Anchorage Press.
  12. Celiac.com 08/01/2011 - Over the last two decades, there has been a marked increase in the prevalence of celiac disease, especially the sub-clinical celiac disease forms and non-celiac gluten sensitivity. Most people with celiac disease now present atypical or non-classical symptoms. However, even with improved evaluation methods, clinicians may often face variable histological and clinical presentations of celiac disease, and they may be confused by diagnostic models in the current guidelines. A team of researchers recently set out to reassess sub-clinical celiac disease and gluten sensitivity. The study team included Mohammad Rostami Nejad, Sabine Hogg- Kollars, Sauid Ishaq, Kamran Rostami They are affiliated variously with the Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran, School of Immunity and Infection, University of Birmingham, and the Dudley Group of Hospital NHS Foundation Trust, both in the UK. Improved celiac evaluation methods, and the discovery such conditions as non-celiac gluten sensitivity have them recommending that clinicians use the term 'sub-clinical' in place of 'silent,' and 'atypical' in place of 'potential/latent,' as a way to better understand clinical atypical celiac disease. Although terminologies like 'latent,' 'silent' and 'potential' do reflect certain observable aspects of clinical and pathological celiac disease, they also cause some confusion between clinicians and patients, in part because the definitions are still somewhat vague and subjective. The researchers point out that 'silent' celiac disease is not actually silent after all. Rather, patients show signs of celiac disease with no significant symptoms. Meanwhile, the terms 'potential' and 'latent' are defined differently across numerous studies. The researchers point out the widening spectrum of gluten related disorders, and note that these common systemic disorders have numerous causes with a variety of symptoms and complications inside and outside the small bowel. They conclude that the body of evidence supports decreasing the treatment threshold in people with atypical celiac disease and gluten sensitivity. Since long-term complications of sub-clinical celiac disease remain unknown, they say, it is appropriate to diagnose such patients as early as possible, and to treat them with a gluten-free diet. Source: Gastroenterology and Hepatology From Bed to Bench. 2011;4(3): 102-108
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