Archive for Celiac Disease
Brain White-Matter Lesions in Celiac Disease
If this article does not give you an idea of how important it is to recognize the impact of food allergies on our overall health, I’m not sure what will. Reactions to food allergies can range from minor GI irritation to irreversible brain damage. Physicians need to begin to recognize the impact that the GI tract has on our overall health. The author suggests that this response is mediated through an upregulation of the immune system leading to focal damage in the brain. Consider this…many people crave the foods they’re allergic to and so eat them very often. That leaves opportunities on almost a daily basis to wreak havoc on our immune systems…
Pediatrics — Abstracts: Kieslich et al. 108 (2): e21
With the virtual avoidance of the fact that food allergies exist and are major contributors to chronic disease, this study has the potential to change the way many doctors view allergies. Unfortunately, they would have to read the article first….
This article reminds me of a patient I had awhile back that had been diagnosed with dermatitis herpatiforms–a skin condition closely linked to celiac disease–10 yrs prior. When he asked his doctor if he should avoid wheat, the doctor said that would be too hard and put him on a drug used for leprosy. Forget the long term damage that a food allergy like this could cause on other organ systems.
Neurology — Abstracts: Chin et al. 60 (10): 1581
No harm from five year ingestion of oats in celiac disease
Oats do contain some gluten which has always prompted the recommendation to stay away from oats in patients with celiac disease. I have always found these tough recommendations and have allowed patients to eat oat on an elimination diet. I am glad that current research seems to support this concept. Given how prevalent gluten insensivity is and how hard it is to eliminate just wheat without any thought to also eliminating oats, this finding will make life a little easier on some patients.
Gut — Abstracts: Janatuinen et al. 50 (3): 332
Causes of Death in Patients With Celiac Disease
Just another reminder of how devastating the condition can be. Essentially, celiac disease is an allergy to the gluten protein in grains, most notably wheat. The levels of gluten is further elevated in “technology” grown grains where fertilizers high in nitrogen are used. I know I have mentioned this patient before, but it warrants bringing him up again. I had a patient awhile back that was diagnosed 10 yrs prior with dermatitis herpatiformis–a skin condition closely linked to wheat allergy. His doctor at that time told him he did not need to avoid wheat–just stay on this drug indefinitely (the drug was commonly used for leprosy). Knowing what we know about celiac disease and its long term effects–that borders on malpractice.
Arch Intern Med — Abstracts: Peters et al. 163 (13): 1566
The Temporal Relationship Between the Onset of Type 1 Diabetes and Celiac Disease: A Study Based on Immunoglobulin A Antitransglutaminase Screening
This is an interesting study. Here’s how it works. We have blood tests that help determine whether a patient has an allergy to gluten containing grains (celiac disease). Children with Type I diabetes have a strong association with celiac disease.
This study finds that the celiac disease can be identified before the onset of Type I diabetes. This is significant because there are interventions that can be effective at slowing or stopping the beta cell destruction in the pancreas such as niacinamide. So, if we have an easy blood test we may be able to intervene and stop the progression to diabetes.
Pediatrics — Abstracts: Peretti et al. 113 (5): e418 -
Celiac disease. Gluten sensitivity. Allergy to wheat. Gluten intolerance. How real is it? And should you go through the trouble to avoid foods that contain gluten?
Gluten free has become the buzz phrase of the decade. It’s not that avoiding gluten was ever a bad idea, but somehow word got out that gluten was bad for you and causes all kinds of bad health conditions. I remember a situation from early in my practice career (maybe 13 or so years ago).
A patient was referred to me for a weird skin lesion on her back. She had been to the U of A dermatology department and called herself the “poster child” down there. At one point she remembered baring her back while a near endless stream of residents and interns paraded past her for a good look. While they tried many meds and creams, nothing was working.
That’s when she came to see me. We discussed food allergies and skin problems (the gut and the skin derive from the same embryological tissues, so what aggravates one tissue may affect the other) and I recommended a 2 week trial of a gluten free diet and “Bingo!” the skin lesions disappeared. They reappeared almost instantly after a reintroduction of wheat after the 2 weeks.
I remember another case where a patient presented with dermatitis herpetiformis, a blister like skin lesion that shows up commonly on the elbows and is very strongly associated with gluten sensitivity. He had been put on Dapsone (an antibiotic used to treat leprosy) about 10 years prior, but the treating doctor told him he did not need to avoid gluten because that was too difficult. I can only assume that this doctor was unaware that the damage to the gut in these patients continues unchecked with Dapsone use, but the skin lesions DO improve. And that’s all that matters, right?
Would you like my take on the gluten free craze? Of course you do–you’re already 322 words into the post.
Clearly gluten sensitivity is very real. It is a spectrum that ranges from minor sensitivity to the gut destroying flattened villa of full blown celiac disease. We are likely seeing an increase because of the combination of nitrogenous fertilizers (increases levels of gluten in grains) and the overuse of antibiotics (there is a cross reactivity between gluten and Candida albican yeast).
I have covered more on the effects of gluten on the body in a previous post that can be read by clicking here.
So what about switching to gluten free foods and avoiding all those foods that contain gluten?
This particular article should give you some reassurance that most of the foods labeled gluten free are actually gluten free. The authors found that the gluten content in 99.5% of 205 commercially available gluten free products tested, the samples had a gluten concentration <20 mg/kg.
Good news, right?
Here’s my take.
We live in a society heavily dominated by grains. It seems like we can’t go a single meal or a single snack without some form of wheat attached to it. And, more often than not, it’s the nearly poisonous enriched wheat flour.
So, after watching Dr. Oz, you decide that avoiding foods that contain gluten is a good idea. So you go to the store and spend way to much money on the exact same type of foods you were eating but this time they are gluten free. Gluten free bread. Gluten free pasta. Gluten free hamburger buns. Gluten free broccoli.
Wait…gluten free broccoli? But isn’t broccoli gluten free anyway? YES. That is the point.
Instead of spending your money and taste buds on the same types of food that got you into this mess in the first place, expand your horizons and eat foods that are naturally free in gluten.
I have to laugh when Sprouts, a local natural-oriented food store, has its “gluten free” sale. Anything in the store that is gluten free is on sale and marked. Not a single food in the fruit and vegetable section has gluten. Nothing at the meat counter. Nothing in the spices (at least not the quality ones).
So, it’s great to know that foods that are labeled gluten free are very likely to be so, why not skip the concept altogether and buy foods that don’t need to be modified so that they no longer contain gluten?
If you have tried a gluten free diet, what was the one food item you missed the most?
Range of Neurologic Disorders in Patients With Celiac Disease
Celiac disease (allergy the the gluten portion of certain grains such as wheat) is one of those conditions that exemplifies the problem with mainstream medicine. While specialties are common, this is not how the body works. Here we have a gastroenterological problem wreaking havoc on the neurological system. I still recall a patient I had several years back. He was diagnosed with dermatatitis herpatiformis 10 yrs prior to coming into my office. This condition is strongly associated with celiac disease.
Did his doctor recommend a gluten free lifestyle? No. Gave him dapsone (used for leprosy) and told my patient that a gluten free diet was too difficult. My patient willingly went on a gluten free program with only the mere mention that this would be best for him. I think he always knew this was best but was never told this. How much damage was done to his neurological system in the 10 years before he went on a gluten free diet? Incidently, ADD/ADHD was one of the conditions noted in this article as being related to CD.
Pediatrics — Abstracts: Zelnik et al. 113 (6): 1672 -
Antigliadin antibodies in Huntington’s disease
Gluten insensitivity, Celiac disease–whatever you call it, the impacts on those with the sensitivity is great. A recent review in the Updates showed that those with celiac disease had an overall greater mortality rate. With the advent of commercially grown grains, the gluten content has increased in an attempt for the plant to store the excess nitrogen. This, coupled with the ubiquitous presence in processed foods, are probably the main contributors to the common nature of this condition.
Neurology — Abstracts: Bushara et al. 62 (1): 132 -
Accuracy of Ultrasonography in Predicting Celiac Disease
Given the high prevalence of CD and it’s major impact on our health, diagnostic tests that help determine its presence are always welcome. Anti tissue transglutaminase antibodies (tTG) and anti-endomyssium antibodies (EMA) are blood tests that are also useful for diagnosing celiac disease.
Arch Intern Med — Abstracts: Fraquelli et al. 164 (2): 169 -
Is Candida albicans a trigger in the onset of celiac disease?
This would answer an awful lot of questions. Basically, due to a cross reactivity between a protein found in C. albicans and a protein found in gluten, an infection with candida can initiate the onset of celiac disease in genetically suseptable patients.