Celiac Disease

Discussing the latest advances in celiac disease

July 24th, 2014 · Leave a Comment

Gluten-Free Recipe: Grilled Pineapple

By Margaret Shepard

Take advantage of a hot grill and grill up some dessert! This recipe for grilled pineapple is a good source of vitamin C as well as gluten-free.

Ingredients

For the marinade

1 tablespoon olive oil
1/4 teaspoon ground cloves
1 teaspoon ground cinnamon
2 tablespoons dark honey
1 tablespoon fresh lime juice
1 firm yet ripe pineapple
1 tablespoon dark rum (optional)
1 tablespoon grated lime zest

Directions

Prepare a hot fire in a charcoal grill or heat a gas grill or broiler (grill).

To make the marinade, in a large bowl, combine the olive oil, cloves, cinnamon, honey and lime juice and whisk to blend. Set aside.

Cut off the crown of leaves and the base of the pineapple. Stand the pineapple upright and, using a large, sharp knife, pare off the skin, cutting downward just below the surface in long, vertical strips. Cut off any remaining small brown "eyes" on the fruit. Stand the peeled pineapple upright and cut it in half lengthwise. Place each pineapple half cut-side down and cut it lengthwise into four long wedges; slice away the core.

Place the pineapple in the bowl with the marinade and stir to coat the pineapple.

Place on the grill and cook about 3 to 4 minutes, basting once or twice with the remaining marinade. Turn the fruit and move it to a cooler part of the grill or reduce the heat. Baste again with the marinade. Grill until the pineapple is tender and golden, about 3 more minutes.

Remove the pineapple from the grill and place on a platter or individual serving plates. Brush with the rum, if using, and sprinkle with the lime zest. Serve hot or warm.

Recipe originally posted on mayoclinic.org

Tags: Friday recipe, gluten free, gluten free diet, gluten free recipe, healthy living

July 17th, 2014 · Leave a Comment

A Pill for Celiac Disease?

By Margaret Shepard

Joseph Murray, M.D., discusses a recently published article in Gastroenterology about a pill for the treatment of celiac disease.

 

For decades, celiac disease has been treated solely by a gluten-free diet. This proof-of-concept paper shows that a digestive enzyme engineered to specifically break down gluten proteins seems to be effective at preventing damage of the intestine.

Normally, patients with celiac disease on a gluten-free diet are challenged with gluten. The challenge induces inflammation or irritation of the intestine and symptoms. This study from Finland uses a novel preparation of two, custom designed enzymes that break down the particular damaging parts of the gluten proteins. The two enzymes combine in a way to increase the maximum efficiency of breaking down the parts of gluten that drive the disease.

In this clinical study, patients with well-treated celiac disease on gluten-free diet and healed intestines were challenged with gluten at a dose that would induce injury. In the group that received the placebo, there was significant injury seen. The patients that received the drug were protected from this damage to a significant degree.

What does this mean for people with celiac disease? This is an experimental agent being studied in a large international study, including North America, in patients with symptomatic celiac disease. The hope is that it can improve the damage or inflammation to the intestine while also improving symptoms. There are many challenges before this drug, or other drugs, can reach the marketplace. There are more studies underway with other agents and it's an exciting time to be involved with celiac disease.

Read the full study online here.

For more information on celiac disease, visit mayoclinic.org/celiacdisease.

Dr. Murray is a gastroenterologist and celiac disease expert at Mayo Clinic.

Tags: AGA, celiac disease, enzyme, Gastroenterology, gluten free diet, Joseph Murray, pill

July 10th, 2014 · Leave a Comment

Celiac Disease and Brain Fog

By Margaret Shepard

Joseph Murray, M.D., discusses a recently published article in Alimentary Pharmacology & Therapeutics about brain fog and celiac disease.

 

For people with celiac disease, brain fog implies significant cognitive impairment. Brain fog indicates problems with thinking, memory, recall, and computation. Brain fog can lead to significant mental fatigue.

This recent study took place in Australia and closely followed a small group of patients with celiac disease. The researchers tested their mental ability with multiple tests at the time of diagnosis and at 12 and 52 weeks later. They also followed their symptoms with blood tests and biopsies. At 12 weeks, patients showed significant improvement in all of the measures, especially antibody tests and biopsies. Most interestedly, the patients showed a significant improvement in cognitive ability over time. This suggests that not only does celiac disease impair cognitive function but a gluten-free diet improves it.

More information and studies needs to be done on this subject of brain fog and how celiac disease impairs brain function. There's hope for patients with celiac disease that their cognitive function will improve once they are appropriately treated.

Read the full study online here.

For more information on celiac disease, visit mayoclinic.org/celiacdisease.

Dr. Murray is a gastroenterologist and celiac disease expert at Mayo Clinic.

Tags: brain fog, celiac disease, cognitive impairment, Joseph Murray

July 1st, 2014 · Leave a Comment

Gluten-Free Recipe: Grilled Chicken Salad with Olives and Oranges

By Margaret Shepard

Heading to a 4th of July picnic this week? Bring this grilled chicken salad with olives and oranges to share! The garlic-rubbed grilled chicken is a nice complement to the tangy dressing.

Ingredients

For the dressing

1/2 cup red wine vinegar
4 garlic cloves, minced
1 tablespoon extra-virgin olive oil
1 tablespoon finely chopped red onion
1 tablespoon finely chopped celery
Cracked black pepper, to taste
4 boneless, skinless chicken breasts, each 4 ounces
2 garlic cloves
8 cups leaf lettuce, washed and dried
16 large ripe (black) olives
2 navel oranges, peeled and sliced

Directions

To make the dressing, in a small bowl combine the vinegar, garlic, olive oil, onion, celery and pepper. Stir to mix evenly. Cover and refrigerate until needed.

Prepare a hot fire in a charcoal grill or heat a gas grill or broiler. Away from the heat source, lightly coat the grill rack or broiler pan with cooking spray. Position the cooking rack 4 to 6 inches from the heat source.

Rub the chicken breasts with garlic, then discard the cloves. Grill or broil the chicken until browned and just cooked through, about 5 minutes each side. Transfer the chicken to a cutting board and let rest 5 minutes before slicing into strips.

Arrange 2 cups lettuce, 4 olives and 1/4 of the sliced oranges onto 4 plates. Top with 1/4 of the chicken strips and drizzle with dressing. Serve immediately.

Originally posted on mayoclinic.org.

For more information on celiac disease, visit mayoclinic.org/celiacdisease.

Tags: gluten free, gluten free recipe, healthy living, recipe, salad

June 26th, 2014 · Leave a Comment

Mucosal Healing in Kids with Celiac Disease

By Margaret Shepard

Imad Absah, M.D., discusses a recently published article in the Journal of Pediatric Gastroenterology and Nutrition about mucosal healing in children with celiac disease. The results show that children with celiac disease may not have as complete mucosal healing as previously thought.

 

There is no test to detect the rate of mucosal healing. The rate of healing in children has historically been within 6 - 12 months of beginning a gluten-free diet. This study looked at hospital records between 1997 and 2013. The researchers identified all the children with celiac disease and looked into the records that showed repeat biopsies. The researchers found 40 children out of 222, about 18%, had a small bowel biopsy repeated. The time frame between the first and second biopsy was 24 months.

The results showed only 25 of the children had complete healing. 9 of the children had mild inflammation with intraepithelial lymphocytes and 6 had persistent villous atrophy. The researchers did not find any correlation between the symptoms and villous atrophy. There were 20 patients with abdominal pain and only 2 had persistent injury to the gut.

Downsides of the study are it's retrospective, a small sample size, and most of the children with repeat biopsies has symptoms. Most of the children had abdominal pain, diarrhea, and constipation.

In this selected group of patients treated celiac disease, only 64% had complete healing of the gut. There was no correlation between the persistent symptoms and mucosal healing.

Read the full study online here.

For more information on celiac disease, visit mayoclinic.org/celiacdisease.

Dr. Absah is a pediatric gastroenterologist at Mayo Clinic.

Interested in learning more about research studies, opportunities, and study results? Visit the National Foundation for Celiac Awareness' Research Opt-In.

Tags: celiac disease, gluten free diet, Imad Absah, injury to the gut, mucosal healing, pediatric

June 20th, 2014 · Leave a Comment

Friday Recipe: Broiled Scallops with Sweet Lime Sauce

By Margaret Shepard

Wondering what to make for dinner tonight? Try this recipe for broiled scallops with a sweet lime sauce. Instead of a fatty lime sauce, this recipe coats the broiled scallops in honey and lime juice.

Ingredients

4 tablespoons honey
2 tablespoons lime juice
1 tablespoon olive or canola oil
1 pound bay or sea scallops, rinsed and patted dry
2 teaspoons grated lime peel
1 lime, cut into 4 wedges
Directions

Preheat the broiler. Position the rack 4 inches from the heat source. Cover a broiler pan or cookie sheet with aluminum foil. Spray generously with cooking spray.

In a large bowl, whisk together the honey, lime juice and oil. Add the scallops and toss gently to coat with the honey mixture.

Arrange the scallops in a single layer on the prepared broiler pan or baking sheet. Broil until opaque throughout when tested with a tip of a knife, about 5 minutes. Turn the scallops over and broil for another minute.

Divide the scallops onto 4 warmed plates. Pour any juices from the broiler pan or baking sheet over the scallops. Sprinkle with grated lime peel and serve with a lime wedge.

Recipe originally posted on mayoclinic.org.

For more information on celiac disease, visit mayoclinic.org/celiacdisease.

 

Tags: broiled scallops, Friday recipe, gluten free, gluten free recipe, recipe

June 13th, 2014 · Leave a Comment

Non-Celiac Gluten Sensitivity and Fructan

By Margaret Shepard

Joseph Murray, M.D., discusses a journal article published in Gastroenterology about non-celiac gluten sensitivity. The results of the study show non-celiac gluten sensitivity is a misnomer that should be labeled as a wheat intolerance to fructan.

About three years ago, a group from Australia published a paper saying there was non-celiac gluten sensitivity. This study was conducted with a group of volunteers who reported benefits of their irritable bowel syndrome (IBS) symptoms from going gluten-free. The researchers made sure the patients didn't have celiac disease and then put them in a double blind, placebo controlled challenge with gluten. The results showed people could get symptoms from gluten that was not predicted by the usual factors that predict celiac disease. This study started an interest in non-celaic gluten sensitivity.

The same research group undertook a similar, more detailed study that came out last year. This study again recruited people that had IBS symptoms who reported benefits of going gluten-free. Before the researchers started the patients on a gluten challenge, they recorded the patients intake of FODMAPs. FODMAPs are components of foods that are small sugars, fermented, and have osmotic properties. The researchers restricted the patients intake of FODMAPs for a couple of weeks and during that time period, the patients didn't have the residual symptoms they had been having. Once the researchers challenged the patients with gluten, the patients didn't get symptoms in response to gluten. The researchers challenged the patients a second time on a more restrictive diet and the patients, again, didn't have symptoms from gluten.

What does all of this mean? Perhaps the patients thought to be gluten sensitive aren't affected by the gluten. The researchers of this particular study suggest it might be fructan causing the gluten-responsive symptoms. Fructan is a component of wheat that act like a FODMAP. Perhaps non-celiac gluten sensitivity patients have a wheat sensitivity due to fructan. A lot more research needs to be done to figure out how much of a role fructan is playing in creating non-celiac gluten sensitivity symptoms.

What does this matter to patients? If patients feel better by avoiding gluten, it is still important to tested for celiac disease. Physicians need to find that out before a patient goes gluten-free. A patient that has celiac disease has chronic inflammation of the intestine and could have complications.

Read the full study online here.

For more information on celiac disease, visit mayoclinic.org/celiacdisease.

Dr. Murray is a gastroenterologist and celiac disease expert at Mayo Clinic.

Tags: celiac disease, fructan, Gastroenterology, gluten, gluten sensitivity, Joseph Murray, non-celiac gluten sensitivity

June 6th, 2014 · Leave a Comment

Celiac Disease or Non-Celiac Gluten Sensitivity?

By Margaret Shepard

Joseph Murray, M. D., discusses a recently published journal article in the American Journal of Gastroenterology about the diagnosis difference between celiac disease and non-celiac gluten sensitivity.

The article, published by two different centers in Boston, examines and tries to differentiate between celiac disease and non-celiac gluten sensitivity in over 200 patients. The patients examined had incomplete or no testing before going on a gluten free diet.

The results the authors found were interesting and constructive. Patients who had symptoms of malabsorption, deficient in certain nutrients, a family history of celiac disease or autoimmune disease were much more likely to have celiac disease than patients who lacked any of those features. Another strong indicator of celiac disease was a positive blood test result in patients who had some blood testing for celiac disease before going on a gluten-free diet. Patients who lacked those features or the antibody tests were less likely to have celiac disease.

The authors also point out the usefulness of genetic testing in patients who have some of the features of celiac disease or blood tests that are borderline or weak positive. Genetic testing might be helpful in selecting those patients who need further testing. This points out the importance of being tested for celiac disease before going on a gluten-free diet. It is easier to test and make sure the right tests are completed to confirm or rule out celiac disease before trying a gluten-free diet.

Read the full article online here.

For more information on celiac disease, visit mayoclinic.org/celiacdisease.

Dr. Murray is a gastroenterologist and celiac disease expert at Mayo Clinic.

Tags: AJG, celiac disease, gluten free, gluten sensitivity, Joseph Murray, non-celiac gluten sensitivity

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