A Milligram of Gluten a Day Keeps the Mucosal Recovery Away: A Case Report

Biagi, Federico; Campanella, Jonia; Martucci, Susi; Pezzimenti, D.; Ciclitira, Paul J.; Ellis, H. A.; Corazza, Gino Roberto

doi:10.1111/j.1753-4887.2004.tb00062.x

Cited by 49 publications

(22 citation statements)

References 18 publications

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“…If left untreated, celiac disease has been linked to small, but signifi cant increases in the risks for several serious long-term health complications including intestinal and bowel cancers, osteoporosis, and infertility ( 2 ). Th e amount of gluten shown to prevent histological recovery has been reported to be as small as 1 mg per day ( 3 ), meaning that strict adherence in this population is of the utmost importance.…”

Section: Introductionmentioning

confidence: 99%

A Randomized Controlled Trial of an Online Intervention to Improve Gluten-Free Diet Adherence in Celiac Disease

Sainsbury

Mullan²,

Sharpe³

2013

American Journal of Gastroenterology

121

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Section: Introductionmentioning

confidence: 99%

A Randomized Controlled Trial of an Online Intervention to Improve Gluten-Free Diet Adherence in Celiac Disease

Sainsbury

Mullan²,

Sharpe³

2013

American Journal of Gastroenterology

121

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“…A wide range exists in the literature, going from <10 to 200 ppm (100ppm/day=30 mg gluten) [21,22,23,24]. More provocative is the case report showing that "A milligram of gluten a day keeps the mucosal recovery away" [25], raising the question: Is it the compliance, not milligrams of gluten that is essential in the treatment of celiac disease? [26].…”

Section: Gfd Is Not Standardized and Its CD Customers Are Quite Confusedmentioning

confidence: 99%

Gluten-free Diet - Tough Alley in Torrid Time

Lerner¹,

Tenbusch²

2017

IJCD

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Dietitians play a pivotal role in the education, follow-up and navigation of the gluten-free diet for patients affected by celiac disease. Since gluten withdrawal is the cornerstone of celiac disease therapy, and since various future therapeutic strategies, are not yet on the market, the patients relay heavily on the registered dietitian nutritionists (RDNs) advice and service to cope with the gluten-free diet tough alley. Unfortunately, gluten withdrawal, nowadays, represent also a torrid time. The actual surge in incidence, wheat content, gluten intake, celiac disease-related T-cell stimulatory epitopes in wheat, usage in the processed food industries, nutritional deficiencies, changing phenotype and the fact that gluten is potentially detrimental to humankind health, make the RDNs role more complex, difficult and challenging. The present review expands on the gluten-free diet related tough alley in torrid time, which the registered dietitian nutritionists are facing when dealing with gluten-sensitive patients.

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“…There is a global debate about the gluten standard as the Codex Committee on Nutrition and Foods for Special Dietary Uses awaits further scientific evidence to support a threshold or tolerance level. Studies indicate that Codex wheat-starch products are safe for the majority of patients with CD (Ciclitira et al 1984(Ciclitira et al , 1985Kaukinen et al 1999), but there have been studies that indicate that some individuals continue to have symptoms on these products (Biagi et al 2004), which resolve when the products are discontinued (Chartrand et al 1997;Faulkner-Hogg et al 1999;Peraaho et al 2003). One of the issues relating to the Codex standard and the inclusion of Codex wheat-starch products, or other products such as malted breakfast cereals or oats, that may contain low levels of gluten is recognition that there is an additive effect of eating a low level of gluten and there are considerable differences between individuals with CD in their response to gluten ingestion (Ciclitira et al 2005).…”

Section: Gluten-free Standardmentioning

confidence: 99%

Coeliac disease: a diverse clinical syndrome caused by intolerance of wheat, barley and rye

McGough

Cummings

2005

Proc. Nutr. Soc.

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Coeliac disease is a lifelong intolerance to the gluten found in wheat, barley and rye, and some patients are also sensitive to oats. The disease is genetically determined, with 10% of the first-degree relatives affected and 75% of monozygotic twins being concordant. Of the patients with coeliac disease 95% are human leucocyte antigen (HLA)-DQ2 or HLA-DQ8 positive. Characteristically, the jejunal mucosa becomes damaged by a T-cell-mediated autoimmune response that is thought to be initiated by a 33-mer peptide fragment in A2 gliadin, and patients with this disorder have raised levels of anti-endomysium and tissue transglutaminase antibodies in their blood. Coeliac disease is the major diagnosable food intolerance and, with the advent of a simple blood test for case finding, prevalence rates are thought to be approximately 1:100. Classically, the condition presented with malabsorption and failure to thrive in infancy, but this picture has now been overtaken by the much more common presentation in adults, usually with non-specific symptoms such as tiredness and anaemia, disturbance in bowel habit or following low-impact bone fractures. Small intestinal biopsy is necessary for diagnosis and shows a characteristically flat appearance with crypt hypoplasia and infiltration of the epithelium with lymphocytes. Diet is the key to management and a gluten-free diet effectively cures the condition. However, this commitment is lifelong and many aisles in the supermarket are effectively closed to individuals with coeliac disease. Compliance can be monitored by measuring antibodies in blood, which revert to negative after 6–9 months. Patients with minor symptoms, who are found incidentally to have coeliac disease, often ask whether it is necessary to adhere to the diet. Current advice is that dietary adherence is necessary to avoid the long-term complications, which are, principally, osteoporosis and small bowel lymphoma. However, risk of these complications diminishes very considerably in patients who are on a gluten-free diet.

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A Milligram of Gluten a Day Keeps the Mucosal Recovery Away: A Case Report

Cited by 49 publications

References 18 publications

A Randomized Controlled Trial of an Online Intervention to Improve Gluten-Free Diet Adherence in Celiac Disease

A Randomized Controlled Trial of an Online Intervention to Improve Gluten-Free Diet Adherence in Celiac Disease

Gluten-free Diet - Tough Alley in Torrid Time

Coeliac disease: a diverse clinical syndrome caused by intolerance of wheat, barley and rye

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