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Showing results for tags 'reflux'.
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Celiac.com 08/23/2023 - Distal gastrectomy has been a common treatment for peptic ulcers and gastroesophageal reflux disease. However, questions have arisen about its impact on gastric mucosa. A team of researchers recently looked into the connection between distal gastrectomy and Helicobacter pylori infection, as well as celiac disease. The research team included Kubilay Issever, Ersin Kuloglu, Demet Sengul, Ali Muhtaroglu, and Ahmet Cumhur Dulger. They are variously affiliated with the departments of Internal Medicine, Pathology, and General Surgery at Giresun University Medical Faculty in Giresun, Turkey. Observational Retrospective Study Focused on Two Groups of Dyspepsia Patients Conducted at Giresun University Faculty of Medicine, the observational retrospective study focused on two groups of patients with dyspepsia. The first group, termed the antrectomy group, consisted of 35 individuals who had undergone distal gastrectomy for benign causes. The second, the control group, included 50 dyspepsia patients who had not undergone gastrectomy. Results showed that the antrectomy group had a higher proportion of older male patients. Lab parameters revealed significant differences: platelets, lymphocytes, and albumin levels were lower in the antrectomy group, while urea, creatinine, and antibodies like anti-Endomisium Ig A (anti-EMA) and anti-tissue transglutaminase IgA (anti-tTGA) were higher. Gastric biopsy results unveiled greater instances of Helicobacter pylori infection, tissue atrophy, neutrophil, and lymphocyte infiltration in the antrectomy group compared to the control group. Further analysis showed correlations of note. An inverse relationship was found between albumin levels and the presence of anti-EMA antibodies or tissue atrophy. Conversely, a positive correlation existed between anti-EMA antibody presence and both Helicobacter pylori infection and tissue atrophy. Distal Gastrectomy for Dyspepsia Patients More Likely to Have Helicobacter Pylori Infection and Celiac Disease The study's implications are significant. People who have undergone distal gastrectomy for dyspepsia may be more susceptible to complications tied to Helicobacter pylori infection and celiac disease. The potential for Helicobacter pylori infections to progress into malignancies raises concerns. As a result, routine screening and interventions to eliminate Helicobacter pylori infections are paramount to prevent malignant transformations in the remaining gastric tissue. This study underscores the potential risks stemming from distal gastrectomy, especially its association with Helicobacter pylori infection and celiac disease. This knowledge will help medical practitioners to better navigate post-gastrectomy care, more effectively manage potential complications, and better plan preventive measures. This study does not indicate whether the increased celiac disease risk was a result of the distal gastrectomy, or whether the patients who underwent a distal gastrectomy may have had undiagnosed celiac disease before this treatment. Logically the results of this study might indicate that routine screenings for celiac disease should be done before any distal gastrectomy surgery to rule it out. Read more at Cureus.com
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Celiac.com 12/17/2021 - Gastro-esophageal reflux disease, or GERD, is the focus of considerable medical attention at the moment. This very old problem has gotten some new attention as it has recently been recognized as a significant factor in some pulmonary diseases(1) and esophageal malignancies(2). While some sufferers have few or no symptoms of reflux disease, most of us feel at least some degree of discomfort when a mixture of food particles and stomach acids are pushed back up the esophagus where there is less protection from harsh stomach acid. The protection diminishes the further up the esophagus the acid rises as there is some mucous produced in the lower reaches of the esophagus nearer the stomach. The unprotected tissues further up the esophagus are burned, often causing pain, and sometimes, permanent damage(2). We need only turn on our television sets to see the frequent and expensive advertising campaigns for the various products available to treat this widespread problem of indigestion and heartburn. If you regularly experience heartburn or indigestion, you may take one of the many drugs that are often prescribed to reduce production of stomach acid. Or you may just take one or more of the over-the-counter remedies such as Tums, Gaviscon, Rolaids, Mylanta, etc. But all of these products, whether prescribed or not, simply mask the symptoms of GERD without addressing the underlying cause. Many of us who have gluten-induced disease have experienced some degree of relief from GERD symptoms after beginning a gluten-free diet. Prior to my diagnosis of celiac disease, I not only took prescription medications in a vain attempt to control the acidity in my stomach and throat, I also ate a huge quantity of Tums and/or Rolaids every day, all day long. The lucky ones among us experience complete, long-lasting relief from indigestion and heartburn. For those of us who aren’t so lucky, the problem may be caused by one or more of several factors such as smoking, excessive alcohol consumption, or allergic reactions to the foods we are eating. If you struggle with excess acid production and/or esophageal reflux, it may be the result of your immune system reacting to the contents of your stomach. When such immune reactions are mounted, histamine is released into the stomach which triggers excessive secretion of gastric acid. If there isn’t enough food in the stomach to absorb the acid produced, we begin to feel uncomfortable. We may eat more food to get temporary relief or we may take one or more of the remedies listed above. Weight gain and obesity are predictable results of eating more and more to control stomach acid production. Prescription and non-prescription anti-acid strategies pose a host of other health problems—from inducing vitamin deficiencies— to compromising the immune protection provided by stomach acids. Whatever we choose, GERD is likely to continue until we address the underlying problem by eliminating allergenic foods from our diet. The first step in this elimination process is to identify the foods that are triggering an immune response. There are simple, convenient IgG antibody blood tests available to help identify the specific foods that are causing your discomfort. If you are following a gluten-free diet and you continue to experience GERD, you may benefit from this testing. However, if you have been free of gluten for more than a few months, you should not expect these tests to identify any of the gluten grains (Also, such negative results should not be taken to imply that it is safe to return to eating gluten). Once the allergenic foods have been identified, they should be strictly removed from your diet for at least six months. You can try re-introducing the offending foods after that time, but some immune reactions may last many years. Even six years after my own IgG food allergy testing, I must still avoid eggs, dairy proteins, and several other foods that were identified back then. The lab that did my testing (Immuno Labs, Ft. Lauderdale) provided information on the strength of the immune reaction to each allergenic food. From weak to strong, the reactions were numbered +1 to + 4. This has been very helpful because I was able to re-introduce most of the foods marked +1 and +2 after about six months. Whether you follow a gluten-free diet or not, if you are experiencing heartburn and/ or indigestion, food allergy testing may be just what you need. It has proven very helpful to my family and me. References: Katz PO. Gastroesophageal reflux disease and extraesophageal disease. Rev Gastroenterol Disord. 2005;5 Suppl 2:31-8. Suzuki H, Iijima K, Scobie G, Fyfe V, McColl KE. Nitrate and nitrosative chemistry within Barrett’s oesophagus during acid reflux. Gut. 2005 Nov;54(11):1527-35.
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I had a rant here about 3 months ago after I received the results of my own biopsy, and was advised to go gluten free anyway, which I still haven't done but I'm experimenting with foods and hope to be gluten free soon. I wanted to come here and ask your advice again, because my dad had a biopsy about 4 weeks ago, the results of which came today, and I am so surprised to read they're negative. They told him it was very likely that he had celiac because his blood test was transglutaminase positive. He has low iron, low vitamin D, reflux, and his long-term symptoms of M.E/Chronic Fatigue Syndrome which I know are also common symptoms of celiac. Everyone was sure he might have it, so I don't understand why his biopsy was "normal with no evidence" of the disease. The letter does however suggest further blood tests to see if he might develop celiac disease in the future. If his immune system is attacking and it's showing in his blood, doesn't that mean he's already developed it? Why would it do that if he didn't have celiac going on now? I've been encouraging him to try gluten free bread and biscuits but he's been reluctant, now he definitely won't. Should he? Or should he wave the whole thing off and continue eating his sandwiches like he did quite happily today? I guess they will tell him at the appointment. It's just so ridiculous because after he eats wheat he gets reflux! I was also counting on his results being positive... Sorry I'm rehashing my story now, but since 2011 I've had severe, chronic reflux that has gotten worse with time and has remained a mystery after a barium, manometry and two endoscopies; IBS; light headedness/heavy/cotton wool head with brain fog; headaches and jaw pain; muscle pain and severe weakness; sensitivity to noise, light, and heat, also the sun; fatigue and crashing after activity; bone pain; also severe acne that only responds to antibiotics; dry and flaky skin; brittle, cracked and peeling nails; year-round allergies, like having a mild cold permanently; and the occasional mouth ulcer and bleeding gums. The absolute worst is the reflux, followed by the IBS and then my head. I haven't been able to spin in a circle for years. I can't dance. Can't exercise. I feel so dizzy and sick all the time. Can't bend over or lie down with the reflux. Have cut out all acidic foods and FODMAPS. I am underweight. The reflux doesn't allow me to drink much water now because it feels like I have a little ocean of acid/bile sitting in my esophagus and drinking just adds more to it. So my throat has been so dry for months now. Barium and endoscopy both showed acid/bile sitting there, and a hernia. Manometry presumably showed no reason for reflux like a problem with the wave or a loose LES. But my blood work was negative and then my biopsy was negative. I cried on my friend's shoulder when I got that letter, and I've been counting on dad's results since. Now... Now what? I haven't heard from the hospital in 3 months, since my results came back. I don't know if they're waiting to figure out my father before figuring out me, or if they've discarded me. They told me I'm difficult. So I'm looking for gluten free foods but it's difficult without medical support, and being the only one in the house that wants to be gluten free, cross contamination is going to be a constant threat. Just persuading them to have a second toaster is a battle in itself. (Gluten free pancakes are all very well, but not if I put them in that toaster!) Honestly, I'm at my wits' end. I haven't been healthy since 2011. I'm only 28. I don't remember what it feels like to not have reflux, acid, bile; to eat anything with no pain or gas or toilet trips; to spin in a circle or go to amusement parks; what it feels like to have a clear head. I avoid sunny days. This was all triggered and set off at the end of 2011 by panic attacks and a hospital stay. Oh, I forgot to mention that my stools are often pale, like beech furniture (that might be a strange comparison!). I've really just... had it. So I'm not really sure what I'm asking... should we both go gluten free despite negative biopsies? Or might we just have M.E/Chronic Fatigue Syndrome, which my dad was diagnosed with 18 years ago? Thank you for reading!!
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This is my second thread within a few days, sorry it is long! My biopsy results came today, exactly 6 weeks after the endoscopy. They were "reported as normal." And I am honestly devastated. I've been crying all day. I needed those samples to come back positive, because I cannot - no, I will not - go on like this anymore. Some background: I had panic attacks in 2011 that eventually had me hospitalised with a heart rate of 170. After leaving the hospital I noticed I had constant indigestion and light headedness, symptoms that they assured me were due to the heart rate. When things calmed down, they said it was the beta blockers. After coming off the beta blockers, I started questioning my doctors why I had indigestion, acid reflux; why I was now light headed in the cinema, squinting and holding my head from the loud noise; why I was now sensitive to the sun, to light, to heat; and why I had symptoms of IBS. To cut a long story short, I've been getting treatment for IBS and especially the reflux since 2012, with absolutely no success. I've had every test and I now have a hiatal hernia and acid/bile in the esophagus constantly. I've also had muscle pain and severe weakness, and joint pain. After writing my doctor a letter last May, he suggested testing for celiac, as all my symptoms fit and my father had actually been found celiac positive in his last blood test, but my dad had no idea about that until very recently. I've had three blood tests - all negative. I've had a biopsy - negative. And I've been eating copious amount of bread and wheat for many months, and have never felt worse. The doctors tell me that the reflux will just stop on its own one day. I don't think that ever happens. I mentioned that my father had been diagnosed with M.E/Chronic fatigue syndrome in 2000, and that for a long time we've wondered if I might have inherited it. They didn't really say anything to that. I know it's not good to have celiac disease, but it has treatment, and it has hope. There are worse things to be diagnosed with, crohns, even M.E. There is no treatment for those. I don't want to have fundoplication surgery for the reflux and hernia, because it sounds awful and scary. The gastroenterologist didn't even think the surgery was necessary when I last spoke to her. But I really cannot go on with it, I refuse, so without a diagnosis of celiac, what's left for me to do? Just fundoplication. I was prepared to replace my food, was planning it. I've been researching for months. I even managed to delude myself into believing I have celiac. When my dad got a letter a couple of weeks ago about his last blood test being "strongly suggestive of coeliac disease," I hoped even harder. I thought it was a sign! I feel so foolish. Now I'll have to wait to see the gastroenterologist again to talk about... What? Fundoplication? She didn't even want to do it. She just shrugged and smiled and said I was a difficult patient. I'm going to see my dad's doctor this week, if I can, to talk about how likely it is that I might have celiac after all, regardless of my results, because of my dad's positive blood test, and to discuss the possibility I might have M.E/Chronic fatigue syndrome. In all honesty, I was prepared to look into M.E, until my dad's letter. Then I was even more certain my problem was gluten. Now they tell me, I have no problem with gluten. I feel SO ill right now, I can only describe it as "malaise." My head is light yet heavy, with pressure. My eyes are begging to close. My gut has been painful for over a week. I can feel acid reflux as always. My nails are cracked and peeling, as always. There is blood in my stools. My muscles are painful and so weak that I couldn't stretch out my arm while holding a mug without my arm feeling weak and wobbly. My legs were wobbling as I walked on Saturday. My gums feel as if there could be an ulcer. And I have acne, pale/yellow skin tone, and a headache is threatening. I just can't go on. Really thinking about giving up. I will try to go gluten free anyway, but my mum doesn't believe gluten is my problem and has been sceptical the whole time, so she is reluctant to learn about cross contamination in the kitchen. She just says it's not the problem and it's something else. I don't want to have NCGS because I don't think my doctors/gastroenterologists believe it exists. Thank you for any help :(.
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Celiac.com 04/20/2016 - People with celiac disease very often have reflux symptoms. A team of researchers recently set out to evaluate mucosal integrity and motility of the lower esophagus as possible contributors to reflux symptoms in patients with celiac disease. The research team included María Inés Pinto-Sánchez, Fabio D. Nachman, Claudia Fuxman, Guido Iantorno, Hui Jer Hwang, Andrés Ditaranto, Florencia Costa, Gabriela Longarini, Xuan Yu Wang, Xianxi Huang, Horacio Vázquez, María L. Moreno, Sonia Niveloni, Premysl Bercik, Edgardo Smecuol, Roberto Mazure, Claudio Bilder, Eduardo C. Mauriño, Elena F. Verdu, and Julio C. Bai. They are variously affiliated with the Farncombe Family Digestive Health Research Institute at McMaster University, in Hamilton, Ontario, Canada, the Department of Medicine, "Dr. Carlos Bonorino Udaondo" Gastroenterology Hospital in Buenos Aires, Argentina, Favaloro University Hospital in Buenos Aires, Argentina, Consejo de Investigación en Salud, MSAL, Gobierno de la Ciudad Autónoma de Buenos Aires, Argentina, and with the Gastroenterology Chair, Universidad del Salvador in Buenos Aires, Argentina. For their study, they enrolled newly diagnosed celiac disease patients with and without reflux symptoms, non-celiac patients with classical reflux disease (GERD), and control subjects, who had no reflux symptoms. Using both light microscopy and electron microscopy, they assessed endoscopic biopsies from the distal esophagus for dilated intercellular space (DIS). They used qRT-PC to determine tight junction (TJ) mRNA proteins expression for zonula occludens-1 (ZO-1) and claudin-2 and claudin-3 (CLDN-2; CLDN-3). Overall, patients with active celiac disease showed higher DIS scores than controls, and similar to GERD patients. They found altered DIS even in celiac disease patients without reflux symptoms, who had normalized after one year of a gluten-free diet. Celiac disease patients with and without reflux symptoms had lower expression of ZO-1 than controls. Celiac disease and GERD patients showed similar expression of CLDN-2 and CLDN-3. This study shows that patients with active celiac disease have altered esophageal mucosal integrity, independent of any reflux symptoms. Loss of TJ integrity in the esophageal mucosa may result from altered expression of ZO-1, which may contribute to the development of reflux symptoms. Source: Open Original Shared Link
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Celiac.com 05/21/2015 - Some studies have indicated higher rates of reflux in patients with celiac disease, but there hasn't really been any clear data on the risk for celiac disease in patients presenting with reflux. A team of researchers recently set out to determine rates of celiac disease in patients with GORD, and to better understand the nature of reflux symptoms in newly diagnosed celiac disease patients. The research team included P.D. Mooney, K.E. Evans, M. Kurien, A.D. Hopper, and D.S. Sanders. They are affiliated with the Regional GI and Liver Unit, Royal Hallamshire Hospital, Sheffield, South Yorks, UK. The team divided the patients into groups as follows: Group A included 3368 patients who had undergone routine duodenal biopsy, and prospectively recruited between 2004 and 2014. Researchers compared these results with those of a screening control group. Group B included 32 patients with newly diagnosed celiac disease who had undergone esophageal manometry and 24-h pH studies, prospectively recruited. The results showed the following: Of the 3368 patients in Group A who received routine duodenal biopsy, 850 (25.2%) presented with GORD. Rates of celiac disease among GORD patients was just 1.3% (0.7-2.4%), about the same as in the general population (P=0.53). Routine duodenal biopsy at endoscopy showed that reflux was negatively associated with celiac disease, with an adjusted odds ratio of 0.12 (0.07-0.23), P<0.0001. In group B, about one third of patients complained of reflux. Manometry showed that just under 10% had a hypotensive lower esophageal sphincter, and 40.6% had esophageal motor abnormalities, with 25% showing significant hypocontraction. Also, pH study did show that one in three did in fact suffer reflux episodes. The main takeaway from this study is that GORD patients have undiagnosed celiac disease at about the same rate as the general population, and so routine duodenal biopsy cannot be recommended for patients with GORD. Interestingly, pH/manometry studies showed a fairly high percentage of newly diagnosed celiac patients with reflux and/or esophageal dysmotility; which might explain the high prevalence of reflux symptoms in celiac disease. Source: Eur J Gastroenterol Hepatol. 2015 Jun;27(6):692-7. doi: 10.1097/MEG.0000000000000359.
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Celiac.com 06/28/2013 - Celiac disease has been linked to gastroesophageal reflux disease (GORD) and eosinophilic esophagitis (EoE), but there is very little data from population-based studies on the rates of shared disease among these groups. To get a better picture of the issue, a team of researchers recently set out to conduct a population-based study on rates of celiac disease in people with gastroesophageal reflux disease (GORD) and eosinophilic esophagitis (EoE). The research team included Jonas F. Ludvigsson, Pertti Aro, Marjorie M. Walker, Michael Vieth, Lars Agréus, Nicholas J. Talley, Joseph A. Murray, and Jukka Ronkainen. They are variously affiliated with the Department of Medicine at Karolinska University Hospital and Karolinska Institutet, Clinical Epidemiology Unit, in Stockholm, Sweden, the Department of Pediatrics at Örebro University Hospital in Örebro, Sweden, the Departments of Medicine and Immunology in the Division of Gastroenterology and Hepatology at the Mayo Clinic College of Medicine in Rochester, USA, the Department of NVS, Center for Family and Community Medicine, Karolinska Institutet, Stockholm, Sweden, the Faculty of Health at the University of Newcastle in Newcastle, Australia, the Institute of Pathology in Bayreuth, Germany, the Primary Health Care Center of Tornio, Finland, and the Institute of Health Sciences at the University of Oulu in Oulu, Finland. For their study, the team conducted endoscopes on a thousand randomly selected adults from the general population. They defined celiac disease as positive serology together with mucosal abnormalities of the small intestine. They defined any eosinophil infiltration of the esophageal epithelium as esophageal eosinophilia and EoE was defined as having at least 15 eosinophils/high-power field in biopsies from the distal esophagus. They used Fisher's exact test to compare the prevalence of GORD, esophageal eosinophilia, and EoE in subjects with celiac disease, and to compare the realists with those of the control group. Of the 400 subjects (40%) with gastroesophageal reflux symptoms (GORS), 155 (15.5%) had erosive esophagitis, 16 (1.6%) had Barrett's esophagus, 48 (4.8%) had esophageal eosinophilia, and 11 (1.1%) had EoE. They diagnosed celiac disease in eight (2%) of the 400 individuals with GORS, compared to 10 of 600, or 1.7% for the control group (p = 0.81). They also diagnosed celiac disease in 3 of 155 subjects (1.9%) with erosive esophagitis, compared with 15 of 845 (1.7%) of control subjects (p = 0.75); and 2 cases of celiac disease from the 48 (4.2%) individuals with esophageal eosinophilia (controls were 16 of 952 (1.7%), p = 0.21). They found no celiac disease, however, in any of the 16 subjects with Barrett's esophagus, while they did find 18 cases among the 984, or 1.8% of control subjects; p = 1.0. Nor did they find celiac disease in any of the 11 individuals with EoE, compared with 18 cases in the 989, or 1.8% of control subjects; p = 1.0. Because this population-based showed no increased risk of celiac disease among individuals with GORD, esophageal eosinophilia, or EoE, they conclude that there is no need to conduct celiac screening of individuals with GORD, or EoE screening of individuals with celiac disease. Source: Informa Healthcare. doi:10.3109/00365521.2013.792389
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Celiac.com 12/16/2011 - To date, symptoms of gastroesophageal reflux disease (GERD) - heartburn and acid regurgitation - have been among the only GI symptoms absent from the list of common manifestations of celiac disease. They are usually definitive indicators of gastric acid reflux. But a report from Julio César Bai's group in Buenos Aires notes that at the time of diagnosis, patients with celiac disease were more likely to complain of GERD symptoms than healthy controls. Moreover, maintaining a gluten free diet alleviated these symptoms. Their results are reported in Clinical Gastroenterology and Hepatology.GERD is a chronic condition usually resulting from the reflux of acidic stomach contents up into the esophagus. It is commonly treated with proton pump inhibitors, but some cases are refractory to this treatment. There has been conflicting data as to whether GERD symptoms are more common in people with celiac, and whether a gluten free diet might help. Dr. Bai's group designed a two pronged study to answer these questions: They undertook a cross sectional analysis of 133 people upon their diagnosis with celiac over the course of 2005, and a longitudinal assessment of 53 of them as they maintained a gluten free diet over the next four years. At the time of their diagnosis, the proportion of celiac with reflux was six-fold higher than that in the the 70 healthy controls included in the study. Interestingly, more severe reflux symptoms were associated with the classical, rather than the silent, presentation of celiac disease. However, it should be noted that this was somewhat of a selected population; these data were obtained from patients coming to a malabsorption clinic, where the classic presentation of celiac is more prevalent than the silent type. Moreover, for whatever reason, these healthy volunteers had less GERD symptoms than is usually reported. After three months on a gluten free diet symptoms were comparable to those seen in healthy controls. Interestingly, though, this was the case for patients who reported only partially complying to a gluten free diet as well as those who adhered to it strictly. Because these symptoms are alleviated upon assumption of a gluten free diet, the authors hypothesize that they might be caused by a nontraditional mechanism in celiac patients rather than by actual reflux. One suggestion they posit is reduced upper gastrointestinal motility, and another is a permeability defect in the stratified esophageal epithelium. In an editorial accompanying the paper, delayed gastric emptying and disturbed neuroendocrine control of upper GI function are floated potentially contributing to GERD symptoms in untreated celiac. Further research would have to be done to bear out these and other ideas. Nachman F, Vázquez H, González A, Andrenacci P, Compagni L, Reyes H, Sugai E, Moreno ML, Smecuol E, Hwang HJ, Sánchez IP, Mauriño E, Bai JC. Gastroesophageal reflux symptoms in patients with celiac disease and the effects of a gluten-free diet. Clin Gastroenterol Hepatol. 2011 Mar;9(3):214-9. Epub 2010 Jun 30. Source: Leffler DA, Kelly CP. Celiac disease and gastroesophageal reflux disease: yet another presentation for a clinical chameleon. Clin Gastroenterol Hepatol. 2011 Mar;9(3):192-3. Epub 2010 Dec 8.
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Celiac.com 11/21/2008 - Not much is known about what effects, if any, a gluten-free diet might have upon gastroesophageal reflux disease-related symptoms (GERD-rs) in people with celiac disease. A team of researchers recently set out to assess the recurrence of GERD-rs, in celiac patients with nonerosive reflux disease (NERD). Out of a total of 105 adult patients with celiac disease, the team found 29 with celiac disease who presented with the NERD. Those 29 were enrolled in the study, and compared against a control group of thirty non-celiac patients with NERD. After 8 weeks of PPI treatment the team found that 25 (86.2%) celiac patients saw GERD-rs resolve, compared to just 20 (66.7%) control subjects. The team used clinical means to assess recurrence of GERD-rs at 6, 12, 18, and 24-month intervals after initial proton-pump inhibitor (PPI) treatment were withdrawn for 8 weeks. In the celiac disease group, just five patients (20%) had a recurrence of GERD-rs at 6 months, but none had recurrence at 12, 18, and 24 months, while the control group showed recurrence in six of 20 controls (30%) at 6 months, in another six (12/20, 60%) at 12 months, in another three (15/20, 75%) at 18 months, and in another two (17/20, 85%) at 24 months. This is the first study to evaluate the effect of a gluten free diet in the nonerosive form of GERD in patients with celiac disease, via a clinical long-term follow-up, and the results suggest that a gluten free diet could be helpful reducing GERD symptoms and in preventing of their recurrence. J Gastroenterol Hepatol. 2008;23(9):1368-1372.
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Celiac.com 03/04/2011 - Celiac disease is similar to the inflammatory bowel diseases, ulcerative colitis and Crohn’s disease, in the obvious sense that all are chronic inflammatory disorders of the gastrointestinal tract. But more than that, they all also present daily psychological and social challenges to patients’ lifestyles. In a recent study reported in the European Journal of Gastroenterology and Hepatology, researchers in the United Kingdom examined the prevalence of GI symptoms in patients with these diseases and correlated the incidence of these symptoms with quality of life (QoL). Not surprisingly, they found that increased severity of reflux and irritable bowel syndrome were associated with a diminished QoL. Patients with celiac disease had worse symptoms and QoL than those with ulcerative colitis, but they were better off than people with Crohn’s disease. This cross-sectional study was performed by sending patients surveys through the mail. One thousand and thirty-one people were included; 225 patients with celiac, 228 with ulcerative colitis, 230 with Crohn’s disease, and 348 healthy age- and sex-matched controls. As this was a postal survey, there is a potential inclusion bias – it is possible that those patients faring the worst would be most likely to send back the questionnaires. Seventy one percent of the celiac patients reported adhering to a gluten-free diet, but this was not corroborated endoscopically. One of the surveys assessed physical and mental QoL and another considered depression and anxiety. Participants were also asked to report and rate GI symptoms they had experienced over the past month, including reflux, heartburn, regurgitation, belching, dysphagia (difficulty swallowing), and retrosternal pain. Barrat et al. found that the celiac patients had higher rates of belching and dysphagia than inflammatory bowel diseases sufferers in this study and also than reported previously. They highlight that despite the high (71%) degree of adherence to the gluten-free diet, 22% of celiac patients still reported severe enough IBS symptoms to affect their QoL. They infer from this finding a couple of noteworthy things. First, that the gluten-free diet may not adequately control IBS symptoms in celiac patients. But also, that doctors are perhaps not inquiring about reflux and IBS during consultations, or patients are under-reporting their prevalence. The authors thus suggest that QoL might be improved for these patients if doctors were more diligent in assessing them for reflux and irritable bowel syndrome. Source: European Journal of Gastroenterology & Hepatology: February 2011 - Volume 23 - Issue 2 - p 159–165
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