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Yvonne (Vonnie) Mostat posted an article in Autumn 2018 IssueCeliac.com 10/26/2018 - Did you know that a new study shows people with celiac disease are more likely to suffer nerve damage? Jonas E. Ludvigsson, a clinical epidemiology Professor in Sweden, discovered that women with celiac disease are 2.5 times more likely to develop neuropathy or nerve damage. There is a real association between celiac disease and nerve damage. "We have precise risk assessments in a way we haven't had before" he stated last year. Yet even Sweden has its quandaries. 60% of women in Sweden who have celiac disease have neuropathy and they do not totally know why! Statistics vary from country to country, and even vary between specialists within that country. Nerve damage is no laughing matter, it presents with numbness and tingling of exterior areas (extremities). Basically, numbness in the nerve endings of the fingers and toes and other frustrating areas. Just try picking up pencils, or something hot out of the oven. If you do not feel the heat you will know that you may have nerve damage. Following a rigid gluten-free diet, however, can alleviate this problem to a certain degree, and that is why we keep repeating the mantra: “Eat Clean & Gluten-Free!” However, sometimes accidents happen, and people who have celiac disease, gluten sensitivity, or dermatitis herpetiformis get exposed to gluten. How to Recover From Accidental Gluten Exposure Kathy Holdman, M.S., R.N. and Certified Nutritional Therapist lists numerous ways to recover after gluten exposure. You need to take into account the amount of gluten exposure, length of time from last exposure, degree of gluten intolerance present, health of the digestive tract, existing inflammation or infection in the body and overall health status. Some people say they can recover in a few days, others say they may experience significant setbacks in their health that lasts weeks to months. For those with positive celiac disease it may take years for complete healing of the small intestine after gluten exposure, although "outward symptoms" may resolve sooner. Nurse Holdman suggests the following 10 tips to help alleviate symptoms from gluten exposure, and hopefully speed up recovery: Drink plenty of water, and this cannot be emphasized enough. Water is an essential nutrient for every cell in the body for proper function. Many people live in a state of chronic dehydration, which of course results in constipation. Then they take something to rid themselves of constipation and take too much and lose potassium, magnesium and throw out the balance of the salts in their body. When you have celiac disease you learn something new every week. Last week an Internist told me, after incurring my second bladder infection in eight weeks, that it could possibly be from the diarrhea following being glutened, and not totally washing myself. That made me a little sick just thinking about it. But, she told me an interesting fact about urinary tract infections and celiac disease. Celiacs do incur more frequent urinary tract infections due to more frequent diarrhea, no matter how meticulously clean we are. Taking four or five "Craisins" with each meal several times a day can limit the amount of bladder infections. I told her that I was also taking Cranberry tablets and she told me to throw them out because they are "useless." She said that you do not need to buy fresh cranberries, as they are "sour and expensive." Just buy a bag of the dried Craisins and eat some either before or after meals. Ingredients in the pure dried cranberries helps prevent bladder infections from occurring. Studies done in several Nursing Homes where many incontinent patients lived were given five Craisins either alone or in a salad twice daily and the decrease in urinary tract infections was nothing less than amazing. Get extra sleep and rest. Sleep is the time your body repairs itself. Avoid strenuous exercise, (the type that causes you to sweat). Exercise in moderation is what I think she wants to tell us. Drink bone broth. It is rich in minerals and gelatin and other nutrients that are soothing to the digestive system and nourishing to the entire body. Another health benefit of bone broth is hydration, and the more liquid intake the better. You can dress up bone broth with onions and garlic to improve the taste. Take epson salt baths. They contain magnesium, a mineral that can help the body to relax. The sulphate minerals found in Epson Salts are detoxifying, and they can stimulate the lymphatic system and support the immune system. Nurse Holdman also urges us to take digestive enzymes which can help modulate the symptoms of celiac disease. Take digestive enzymes. If taken immediately following the accidental consumption of gluten, some people believe that digestive enzymes can help to modulate the symptoms of celiac disease. It is well known that digestive enzymes soothe the stomach lining and ease the abdominal pain. Drink ginger or peppermint tea. They are both known to help relieve nausea and can be soothing to the digestive system. Drink a cup if you are having nausea or other gastrointestinal symptoms. Take activated charcoal. It is an over-the-counter-supplement that may be beneficial if taken immediately after an attack. It helps by binding with the offending food and preventing it from being absorbed into the body. This supplement can bind with medications so be sure to consult your licensed health care professional prior to taking it, especially if you take medications for other diseases or conditions. Eat fermented foods. Who knew!? Possibly the Koreans and their staple Kim Chi, or the Ukrainians/Romanians with their fermented red cabbage coleslaw of course! Fermented foods are high in nutrients that nourish the entire body. Start out with a small amount of fermented food and slowly increase it. Drink nettle leaf tea. It is an antispasmodic with antihistamine properties. It can help relieve muscle and joint pain, and relax your body naturally. Neither gluten intolerance nor celiac disease are mediated by histamine, but some people report that nettle leaf can help relieve symptoms of rash and itching following gluten exposure. It is a gentle diuretic and can be detoxifying. So if you experience dehydration symptoms it is time to drink more water. Get acupuncture treatments. It may relieve inflammation, especially in the abdominal area, and it can be relaxing. Only you can tell how many treatments are beneficial, and you need to take into consideration the cost factor because most health insurance plans do not cover acupuncture. Tips to Help People with Dermatitis Herpetiformis Recover from Accidental Gluten Exposure A suggestion from Me: If you have itching from dermatitis herpetaformis, try Scalpacin. I have been using it for years and nothing stops the itching in such a short time span. Once the sores start to appear, even just a slight "itch" is like a doorbell warning you ahead of time. I apply Scalpacin lotion, which is not a cream, but is a clear liquid. At first it stings but that is how I know that I have an impending outbreak. It is a non-fragrant liquid. You can use it on your scalp without totally ruining your hair style. Don't wash you hair with it, search out the spots, or, if you have a partner, they may be able to help you with the sores in your scalp, and you can point out itchy areas. For dermatitis herpetiformis itch you can also try a mix of baking soda and water by making it into a paste. This is not great for your scalp and hair, but it will ease the itching. It can be a little messy when it dries and the white powder flakes off on your floors, but you do not have to use it for hours at a time; it is a temporary method for temporary relief. You can also ask your physician if he or she will prescribe the prescription drug "Atarax" for you. It is a strong allergy medication and must be taken exactly as directed. It really helps the itch, but it can be sedating, especially when first trying it. Don't over-use the prescribed dosage. I would not suggest driving a car while taking Atarax, but if the itching, scabbing and bleeding have become so severe it definitely is the one allergy medication that helps with the itching from dermatitis herpetiformis. I have tried Benadryl, Claritin and other over the counter allergy medications, and nothing works as well as Atarax. Talk to your family physician about a prescription and read the instructions carefully. Hopefully these tips will prove helpful in the unfortunate event that you ever get cross-contaminated by gluten. I certainly hope this never happens to you!
Jefferson Adams posted an article in Celiac Disease & Gluten Intolerance ResearchCeliac.com 11/23/2016 - Researchers know that kids with celiac disease have fully responded to a gluten-free diet when symptoms resolve and serology returns to normal. A team of researchers recently set out to assess the rate of normalization of the TTG and EMA for children on a gluten-free diet after diagnosis. The researchers included Dominica Gidrewicz, Cynthia L Trevenen, Martha Lyon, and J Decker Butzner. After initiated a gluten-free diet in 228 newly diagnosed children with biopsy-proven celiac disease, the team obtained and recorded celiac serologies over a 3.5 year period. The team categorized patients based on serology (Group A, TTG >= 10 x upper limit of normal (ULN) and EMA >= 1:80; Group B, TTG >= 10 x ULN and EMA and EMA <= 1:40; and Group C, TTG < 10 x ULN) and by severity of histologic injury at diagnosis. They found that in children in Group A showed the highest serology at diagnosis. Of those, 79.7% had abnormal TTG at 12 months after diagnosis (average TTG 12 mo, 68.8 +/- 7.3, normal < 20 kU/L). At two years, abnormal TTG persisted in 41.7% of Group A. By contrast, in Group C, which showed the lowest serology at diagnosis, only 35% of children displayed an abnormal TTG at 12 months (average TTG 14.3 +/- 1.9 kU/L). In kids with the most severe mucosal damage, Marsh 3C, 74.2% and 33.2% had an abnormal TTG at 1 and 2 year. The data in this study indicate that 3 out of 4 gluten-free diet compliant kids with the highest celiac serology or most severe mucosal injury at diagnosis, took longer than one year in for serology to return to normal. Doctors should take serology and histology into consideration at diagnosis in order to properly assess the patient's response to the gluten-free diet. That said, it's encouraging that even the more severe cases of celiac disease will eventually return to normal when the kids follow a gluten-free diet. Source: Journal of Pediatric Gastroenterology & Nutrition. doi: 10.1097/MPG.0000000000001270
Wendy Cohan, RN posted an article in Additional Celiac Disease ConcernsCeliac.com 09/25/2008 - Even after identifying yourself as having a wheat or gluten allergy and asking for a specially prepared meal, it is a common mistake to have a server deliver soup with crackers, or the entree with a side of Texas toast. I get frustrated just thinking about the number of times my salad has arrived with croutons. However, getting upset, or pointedly reminding the server can ruin the ambiance of the meal, as well as leave a bad impression with your dinner companions. It is helpful to remember that you are in the very small minority of their customers, and simply consider it an honest mistake. Do not remove the croutons, crackers, cheese, etc. and eat your contaminated food—SEND IT BACK TO THE KITCHEN—politely, please. State that you cannot eat what they have brought you, and repeat that you are allergic to the offending food. Use the opportunity to gently remind your server and educate them about gluten. Hopefully the next time they will be more conscientious. If you are wheat or gluten intolerant, and have the genetic component that leads to celiac disease, there is no going back to gluten. As your body heals, you may think that you will be able to cheat once in a while, and that your sensitivity to gluten will decrease once you are not getting "too much". In fact, the opposite seems to be true. Once the body begins to get rid of its toxic load, heal damaged tissues, and regain health, it becomes more sensitive to gluten. I see this over and over again in the clients I counsel, and in my cooking class students. You will know right away if you cheat, or if you are accidentally "glutened". Your body, fortunately or unfortunately, will tell you. It is important to learn techniques to sooth your symptoms as much as possible until recovery takes place. Symptoms of gluten exposure in a gluten-intolerant person can vary widely, but some commonly reported ones are abdominal discomfort, bloating, pain, swelling (sometimes extreme) and cramping, followed by diarrhea, or loose stools. For those with Dermatitis Herpetiformis (DH), even very minor exposure can provoke itching and a return of a healed or nearly healed rash. Others report headaches, or experience a sudden decrease in alertness and clarity of thought. Short-term treatment strategies for gluten exposure include taking an over-the-counter anti-histamine (check with your pharmacist for gluten ingredients), drinking nettle leaf tea (a natural anti-histamine), and using a warm castor oil pack over your upper or lower abdomen, wherever the pain and cramping are centered. Longer-term strategies include rebuilding your intestinal health through following an anti-inflammatory diet, taking supplements like L-Glutamine, coconut oil, fat-soluble vitamins A, E, D, and K, Calcium, Magnesium, B-Vitamins, Essential Fatty Acids (EFA's), and probiotics. Dr. Thomas O'Bryan, a nationally recognized speaker on celiac disease and gluten sensitivity, also recommends Carnitine, an amino acid, in the treatment of celiac/gluten intolerance. L-Carnitine helps in the absorption and transport of essential fatty acids into cells, and also helps to protect nerve membranes from free-radical damage. You may have good results with the tummy rescue smoothie recipe below, which I developed in response to a "gluten emergency" of my own. The healing properties of each ingredient are also listed. Puree in blender until smooth, and slightly thickened. It is most soothing when consumed while still warm from the hot tea Tummy Rescue Smoothie: 1 cup hot freshly brewed nettle leaf tea (anti-histamine, anti-spasmodic) ¼ cup Santa-Cruz pear juice (flavoring/sweetener - pears are the least allergenic of fruits) ¼ - ½ teaspoon whole fennel seed (reduces gas & bloating) 2 Tablespoons slippery elm powder (healing & soothing to mucous membranes and the gut) 1 Tablespoon flax seed oil (soothing, anti-inflammatory) ¼ - ½ cup rice milk (hypoallergenic, use to thin to desired consistency) This smoothie is best consumed in small sips over an hour or so. Magnesium also helps with pain and relaxes muscle spasms, so taking a little extra magnesium may be of benefit. For severe symptoms, drink the smoothie while reclining in bed, with a warm castor oil pack over the abdomen, covered by a heating pad set on low. Do not leave the pack in place for more than an hour. There is also an enzyme coming on the market that may help reduce some symptoms of gluten exposure, although this product is in no way meant to replace the gluten-free diet. Use it only for emergencies.
Roy Jamron posted an article in Celiac Disease & Gluten Intolerance ResearchCeliac.com 07/31/2006 - A two-year study in the July 2006 Endoscopy showed older celiac patients on a gluten-free diet have an incomplete histological recovery even after two years. Only the younger patients (5 - 30 years) showed significant improvement of histology within 12 months (P < 0.034); older patients (>30 years) showed histological improvement but this was not statistically significant, even after 24 months on a gluten-free diet. This study was also previously discussed in an article by Dr. Antonio Tursi in the Spring 2006 Celiac.com Scott-Free Newsletter. This also means increased intestinal permeability and associated problems such as liver damage may continue to be a lasting problem in older patients beyond two years on a gluten-free diet. Below is the abstract: Endoscopy 2006 July; 38(7): 702-707 Endoscopic and histological findings in the duodenum of adults with celiac disease before and after changing to a gluten-free diet: a 2-year prospective study Tursi, A.; Brandimarte, G.; Giorgetti, G. M.; Elisei, W.; Inchingolo, C. D.; Monardo, E.; Aiello, F. Background and study aims: Published follow-up data on small-intestinal recovery in patients with celiac disease are scarce and contradictory. This is especially the case for adult patients, who often show incomplete histological recovery after starting a gluten-free diet (GFD). We conducted a 2-year prospective study to evaluate the effectiveness of a GFD in improving the endoscopic and histological duodenal findings in adults with celiac disease. Patients and methods: We studied 42 consecutive adults with newly diagnosed celiac disease (13 men, 29 women; mean age 32.7 years, range 15 - 72 years). All the patients underwent esophagogastroduodenoscopy and small bowel biopsy. We devised our own grading system for the endoscopic appearance of the duodenum, which ranged from "normal" appearance to "mild", "moderate", or "severe" alterations. Small bowel biopsies were obtained from the second part of the duodenum (and from the duodenal bulb when it had a micronodular appearance). The histopathological appearances were described according to modified Marsh criteria. Results: A normal endoscopic appearance in the duodenum was found in 5/42 patients (11.9 %) at entry and in 32/42 patients (76.2 %) after 2 years on a GFD. Subdividing the patients according to age, patients aged from 15 years to 60 years showed significant improvement within 12 months (P < 0.0001 for patients aged from 15 years to 45 years; P < 0.003 for patients in the 46 years to 60 years group), whereas the improvement in endoscopic findings in patients older than 60 years was not statistically significant, even 24 months after starting the GFD. "Normal" histology was reported in none of the patients at entry, but in 25 patients (59.5 %) after 24 months on a GFD, but this parameter did not show a significant improvement until the patients had been on the GFD for 12 months (P < 0.0001). Only the younger patients (5 - 30 years) showed significant improvement of histology within 12 months (P < 0.034); older patients (>30 years) showed histological improvement but this was not statistically significant, even after 24 months on a GFD. Conclusions: This study shows for the first time that endoscopic recovery is faster than histological recovery in adults with celiac disease who go on a GFD. Moreover, older patients showed incomplete endoscopic and histological recovery even 24 months after starting a GFD. We therefore advise, as a minimum recommendation, that follow-up biopsies should be taken 1 - 2 years after starting a GFD in adults with celiac disease.