Search the Community
Showing results for tags 'steroids'.
Found 3 results
Celiac.com 05/19/2014 - A research team recently examined the effects of prednisolone and a gluten-free diet on mucosal epithelial cell regeneration and apoptosis in celiac disease. The team included Shalimar, P. Das, V. Sreenivas, S. Datta Gupta, S.K. Panda, and G.K. Makharia. They are with the Department of Gastroenterology and Human Nutrition at the All India Institute of Medical Sciences in Ansari Nagar in New Delhi, India. For their pilot randomized, controlled trial, the team looked at thirty-three untreated patients with celiac disease. They randomly assigned 17 of them to a gluten-free diet alone, and the other 16 to a gluten-free diet + prednisolone. Gluten intake was 1 mg/kg for 4 weeks. The team conducted duodenal biopsies at the start, and at 4 and 8 weeks following treatment. They recruited six patients with functional dyspepsia as control subjects. The team stained all biopsies for markers of intrinsic apoptotic pathway (AIF, H2AX, p53), common apoptotic pathway (CC3, M30), apoptotic inhibitors (XIAP, Bcl2), and epithelial proliferation (Ki-67). They then compared apoptotic (AI) and proliferation indices (PI). Initial duodenal biopsies showed the end apoptotic products H2AX and M30 to be markedly higher. In comparison with those treated with GFD alone, after 4 weeks of GFD + prednisolone treatment, some markers of both intrinsic and common apoptotic pathways showed rapid decline. After prednisolone withdrawal, there was overexpression of H2AX, CC3, and p53 in the latter group. In comparison with those treated with only GFD, patients treated with prednisolone showed suppression of mucosal PI, which started rising again after withdrawal of prednisolone. Apoptosis takes place in mucosal epithelium in celiac disease. The take away here is that a short course of prednisolone quickly suppresses apoptosis. However, it also suppresses epithelial regeneration, an so should be used only for a short time, if at all. Source: Dig Dis Sci. 2012 Dec;57(12):3116-25. doi: 10.1007/s10620-012-2294-1. Epub 2012 Jun 30.
Whether celiac or NCGI or autoimmune disorders, anyone on the forum have or is currently taking steroids? would it only be short term improvement? did it cause more hurt than good? I ask of this as my new GI has me under the NCGI/eosinophillic disorder assumptions currently, since he's confirmed I don't have crohns he would like me to start taking dicyclomine, since he believes it would cause my colon to calm down, as currently what he thinks is a very sensitive small intestine that isnt giving enough time to absorb what it should. (only things i'm deficient on was vit d, weight currently is static) I look at the dicyclomine warnings though, and it boldly states "do not take if you have chronic inflammation". Well isn't that what food intoleranes primarily cause? my fecal calprotection was slightly elevated last year, so I know I have inflammation somewhere. Would steroids be a better route? I know I'm sounding impatient but this is all hypothetical questions if things don't improve, not looking for doctor advise just your guys awesome opionions. Thank you
Celiac.com 05/04/2010 - A team of clinicians recently set out to assess the effectiveness of treating collagenous sprue with a combination of gluten-free diet and steroids. The team was made up of Alberto Rubio-Tapia, Nicholas J. Talley, Suryakanth R. Gurudu, Tsung-Teh Wu, and Joseph A. Murray. They are affiliated variously with the Division of Gastroenterology and Hepatology of the Mayo Clinics in Scottsdale, Arizona, Jacksonville, Florida, and Rochester, Minnesota, and the Division of Anatomic Pathology in Rochester Mayo Clinic. Deposits of subepithelial collagen that form a distinctive band in the small bowel are one of the clinical hallmarks of collagenous sprue. For the study, the team evaluated clinical characteristics, treatments, and outcomes of patients with collagenous sprue. The team looked at medical records for thirty patients with collagenous sprue from the Mayo Clinics from Scottsdale, Jacksonville, and Rochester, for the periods covering 1993 and 2009. 21 of the patients were female (70%), ranging in age from 53–91 years. The majority of patients suffered from severe diarrhea and weight loss. However, collagenous spore is commonly associated with collagen deposits or chronic inflammation in other parts of the gastrointestinal tract, as well as other immune-mediated disorders. 16 patients (53%) were hospitalized to treat dehydration, while 21 patients (70%) suffered from associated immune-mediated diseases, the most common of which was celiac disease. Other common associated diseases included microscopic colitis, hypothyroidism, and autoimmune enteropathy. Subjects showed subepithelial layers of collagen deposits in the small bowel ranging from 20 –56.5Î¼m, and averaging 29 Î¼m thickness. Eight patients showed subepithelial collagen deposits in the colon or stomach. 24 patients (80%) showed a positive clinical response to treatment with a combination of a gluten-free diet and immunosuppressive drugs. Nine patients showed confirmed histologic improvement, while five patients experienced complete remission. Of two patients who died, one succumbed to complications from collagenous sprue, while one died of another illness. Most patients with collagenous sprue show a positive clinical response to a combination of gluten-free diet and steroids. Source: Clinical Gastroenterology and Hepatology 2010;8:344–349. doi:10.1016/j.cgh.2009.12.023