Celiac Disease Update:
1. Celiac Disease and Kid's Minds:
Attention deficits have joined a growing list of neurological problems associated with the intestinal disorder known as celiac disease or celiac sprue.
The disease is caused by a genetic trait that leads to crummy digestion of cereal grains that contain the protein gluten. This gluten intolerance has been recognized for the last half century as a cause of abdominal pain and poor absorption of nutrients. Recently researchers linked the disorder to additional symptoms, including epilepsy, migraines and a condition I've written about before, called sporadic ataxia, which involves reduced muscle control.
Nathaniel Zelnik and his colleagues at Technion-Israel Institute of Technology in Haifa examined 111 kids who had been treated for celiac disease between 1977 and 2001. They also looked at 211 healthy children for comparison. Zelnik's team identified neurological problems in 51 percent of the children with celiac disease and only in 20 percent of the kids without the disease. The team also reports a link between celiac disease and attention deficit/hyperactivity disorder.
This idea that some people with celiac disease develop only the neurological symptoms and do not have digestive symptoms is new and there are many people with the disease who have not been diagnosed. Ruling out celiac disease should now be included on any pediatric workup for ADD or other neurological or learning problems.
Pediatrics. 2004 Jun;113(6):1672-6.
Range of neurologic disorders in patients with celiac disease.
Zelnik N, Pacht A, Obeid R, Lerner A.
[click to read this and related abstracts]
2. New study shows that incidence of celiac disease may be closer to 1 in 80 people.
The Merck Manual that I tried to memorize as a student stated that the prevalence of celiac disease varies from 1 in 300 people in Southwest Ireland to 1 in 5,000 people in North America . We have suspected these numbers were wrong for a number of years. In both dermatitis herpetiformis and sporadic ataxia, conditions that are both caused by celiac disease, digestive symptoms are present less than 15% of the time. As a result it must be assumed that many people who have celiac disease do not display the classic symptoms picture that lead to diagnosis.
A recent study in New Zealand confirms this suspicion. Researchers at the medical school in Christchurch , New Zealand , drafted a thousand study participants off the voter registration roles and subjected them to the detailed laboratory antibody studies now used to screen for Celiac disease. Their results indicate that one person in eighty-two, or about 1.2%, have celiac disease.
J Gastroenterol Hepatol. 2000 Sep;15(9):1032-6.
Adult coeliac disease: prevalence and clinical significance.
Cook HB, Burt MJ, Collett JA, Whitehead MR, Frampton CM, Chapman BA.
[click to view this abstract]
3. Oats are trouble for celiac disease sufferers:
In theory oats contain no gluten protein and should be fine for people with celiac disease to eat. Yet clinical experience has frequently argued against this and left me confused what to recommend. A possible explanation comes from the Celiac Disease Association which points out that oats are processed through the same roller mills as wheat with out cleaning between different grains. It seems that people with celiac disease can be so sensitive to wheat gluten that even the infinitesimal amounts of wheat that are transferred to the oats are enough to trigger symptoms. My new suggestion is going to be for celiac disease patients to purchase whole oats and use a “roller mill” that can be purchased from kitchen specialty stores to flatten the oats for cooking.
4. Wild Oats presents evening class on cooking for celiac disease:
July 19, 2004
invitation to spend the evening with