Celiac Disease

Discussing the latest advances in celiac disease

December 18th, 2014 · Leave a Comment

When to Introduce Gluten to Children

By Margaret Shepard

Imad Absah, M.D., discusses a recently published articles in the New England Journal of Medicine about when to introduce children to gluten.

The main take away of the study is that it most likely doesn't matter when gluten is introduced to a child. It might be reasonable in children with a high risk of celiac disease to check their genotype. Based on genotype and high risk assessment, it might be beneficial to delay gluten introduction to prevent any damage from happening. Breast feeding is still recommending for mothers who have celiac disease because of the benefits for both the infant and the mother.

Read the full article online here.

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

Dr. Absah is a pediatric gastroenterologist at Mayo Clinic.

Tags: celiac disease, gluten, Imad Absah, New England Journal of Medicine, pediatric

December 12th, 2014 · Leave a Comment

Is Gluten The Culprit In Nonresponsive Celiac Disease?

By Margaret Shepard

A gluten-free diet is the only effective treatment for celiac disease, and most adherent patients experience substantial clinical improvement within two weeks, with varying degrees of mucosal healing over time. But a small percentage of patients have malabsorptive symptoms (abdominal pain, diarrhea, weight loss) and histologic abnormalities that persist or recur, despite their best efforts to follow dietary recommendations.

When gluten isn't the issue, Dr. Murray says part of the evaluation should include a review of the original diagnosis — even if it means going back decades. "You have to have a very robust diagnosis. Some patients don't have adequate blood testing and some never had a biopsy because their gastroenterologist told them they didn't need it. Or there could have been an overcall on the biopsy; you have to review the pathology because something else may be damaging the small intestine, such as tropical sprue, which looks like celiac. There may also be drug-induced injury to the small intestine, collagenous sprue or, more rarely, autoimmune enteropathy. It can be very laborious to get the original data, but it may unmake the diagnosis."

Read more in the Digestive Diseases update.

To find out more about celiac disease, visit mayoclinic.org/celiacdisease.

Tags: celiac disease, gluten, Joseph Murray, nonresponsive celiac disease

December 5th, 2014 · Leave a Comment

Gluten-Free Recipe: Chickpea Hummus

By Margaret Shepard

Looking for an appetizer to bring to a holiday party this weekend? Chickpea hummus is a great option that goes with a variety of sides. For a more traditional version, replace the vinegar with lemon juice and the olive oil with tahini (sesame paste).

Ingredients
2/3 cup dried chickpeas (garbanzos), picked over and rinsed, soaked overnight, and drained
3 cups water
2 cloves garlic
1 bay leaf
3/4 teaspoon salt
1 tablespoon olive oil
3/4 cup plus 2 tablespoons sliced green (spring) onion
2 tablespoons sherry vinegar
3 tablespoons chopped fresh cilantro (fresh coriander)
1 teaspoon ground cumin
Directions
In a large saucepan over high heat, combine the chickpeas, water, garlic cloves, bay leaf and 1/2 teaspoon of the salt. Bring to a boil. Reduce the heat to low, cover partially and simmer until the beans are very tender, 50 to 60 minutes. Drain and discard the bay leaf, reserving the garlic and 1/2 cup of the cooking liquid.

In a blender or food processor, combine the chickpeas, cooked garlic, olive oil, 3/4 cup green onion, vinegar, cilantro, cumin and the remaining 1/4 teaspoon salt. Process to puree. Add the reserved cooking liquid, 1 tablespoon at a time, until the mixture has the consistency of a thick spread.

In a small serving bowl, stir together the chickpea mixture and the remaining 2 tablespoons green onion. Serve immediately, or cover and refrigerate until ready to serve. Makes about 1 1/2 cups.

Recipe originally posted on mayoclinic.org.

Tags: Gluten Free, gluten free recipe, healthy living

November 24th, 2014 · 1 Comment

Bone Density

By Margaret Shepard

Bone density and celiac disease are back in the news again thanks to a recent study published in The Journal of Endocrinology and Metabolism.

Raul Ruiz Esponda, M. D., recently discussed the connection between bone density and celiac disease. Watch him talk about how important bone health is for people with celiac disease.

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

Tags: bone density, celiac disease, Raul Ruiz Esponda

November 19th, 2014 · Leave a Comment

Gluten-Free Recipe: Ambrosia with Coconut and Toasted Almonds

By Margaret Shepard

Originally posted on mayoclinic.org.

This Southern classic is pretty and refreshing for dessert or as a snack.

Ingredients
1/2 cup slivered almonds
1/2 cup unsweetened flaked coconut
1 small pineapple, cubed
5 oranges, segmented
2 red apples, cored and diced
1 banana, halved lengthwise, peeled and sliced crosswise
2 tablespoons cream sherry
Fresh mint leaves for garnish

Directions
Preheat the oven to 325 F. Spread the almonds on a baking sheet and bake, stirring occasionally, until golden and fragrant, about 10 minutes. Transfer immediately to a plate to cool. Add the coconut to the sheet and bake, stirring often, until lightly browned, about 10 minutes. Transfer immediately to a plate to cool.

In a large bowl, combine the pineapple, oranges, apples, banana and sherry. Toss gently to mix well. Divide the fruit mixture evenly among individual bowls. Sprinkle evenly with the toasted almonds and coconut and garnish with the mint. Serve immediately.

Tags: Gluten Free, gluten free recipe, healthy living, recipe

November 11th, 2014 · Leave a Comment

Mayo Clinic Going Gluten-Free

By Margaret Shepard

Mayo Clinic Going Gluten-Free is a “backpack for survival” for those who have celiac disease and other related conditions, empowering patients to live productive lives,” said Joseph A. Murray, M.D. gastroenterologist and celiac disease expert at Mayo Clinic.

Dr. Murray discusses his recently published book that helps consumers learn how to manage a gluten-free lifestyle and live healthy lives.

To learn more about celiac disease, visit mayoclinic.org/celiacdisease.

Tags: celiac disease, Gluten Free, Joseph Murray, Mayo Clinic Going Gluten-Free

November 7th, 2014 · Leave a Comment

Betty E. Cornine's Patient Story

By Margaret Shepard

Originally posted on Sharing Mayo Clinic.

I am writing my story of celiac disease. I was diagnosed in March 2008, at the age of 73. I also want to tell my mother’s story. She passed away in 1945 at the age of 30; when I was only 9½ years old.

My mother was sick all her life. I remember her not being able to go anywhere because of diarrhea and being so very sick. At the last part of her sickness she was passing a lot of blood, and her legs were swelled so excessively. She had seen many doctors with no help. The last day they gave her penicillin, but it was too late. Back then, they would only give penicillin to the solider boys. They said she had a new disease!!!!

As we were growing up, my twin brother and I went to live with our grandparents. I was sick off and on my entire life. I married and had a son and daughter.

I suffered with diarrhea, hurting in my stomach, cramps and weight loss. When I gained some weight, I would say (jokingly), “I am going to keep this weight to get sick on.” There was not a clue of what was wrong with me. Tests were done but all they would come up with was irritable bowel syndrome and obstruction of the bile duct.

In the year 2000, I lost 21 pounds in two months. My local physicians couldn’t come up with any answers. I was sent to a specialist in September 2007; all kinds of tests were conducted such as lower and upper endoscopy, C.T. scans, capsule endoscopy and biopsies. Six of these tests were done in 4½ months. I had a lot of polyps the in lower colon removed; one was high grade pre-cancer cells. But, no answers to why I was so sick except an inflammation. They agreed they were missing something! I went back home, made several trips to the emergency room and hospital -- two times my blood pressure was 47/37. There were drastic changes in my eyes, and I went blind in both eyes. My eyes got some better in three weeks, and I could see the Big E. I was losing ground. Two minutes after I would start to eat, I would have diarrhea, and was so sick.

My husband’s health had been failing since 2006, and I was his caregiver. Our daughter and son got two ladies to come in to take care of him. The last trip I made to my local hospital in Missouri on March 14, 2008, my blood pressure was again 47/37. I didn’t think I was going to last very much longer and my doctor AGREED!!!

My symptoms worsened, but no one associated the food with being my problem. My daughter got an appointment for me at Mayo Clinic in Rochester, Minnesota. I left my local hospital on March 23, 2008, and my daughter and I left to go to Mayo Clinic immediately! It took us at least eight hours to get to the Mayo Clinic so my local doctor had suggested I drink Gatorade all the way there. We met with Dr. Glen Alexander at Mayo for the first time at the end of March 2008. After several tests were conducted, Dr. Alexander thought it was likely confirmed that I had collagenous sprue, a disease in which the immune system strikes the body (gluten intolerance). The small intestine is lined with hair-like projections, (called villi). The doctor at Mayo who was treating me said the villi were depleted completely. Then, Dr. Alexander told us that celiac disease was an auto-immune digestive disorder toxic reaction to gluten, which has an increased incidence in family members. When Dr. Alexander said it was more likely to occur in family members, my daughter looked at me, and we both were thinking the same thing -- “Now we know finally what was wrong with my mother when she died.” 63 years ago!!!! Also, the doctor told us what was wrong with my mother and the diseases she had as a child even though he had never met her. We were surprised that he was correct in telling us that she had scarlet fever.

Dr. Alexander gave me medication before I left Mayo Clinic. I have read that celiac disease is not usually treated with drugs, but mine was. When we left the Clinic my feet were swollen. I had worn size 7 women shoes, but we had to get a size 14 wide men’s shoe to come home in.

I was on the medication for one year, and called my doctor at Mayo Clinic every month to report in; he would always call me back and that meant so much to me. In March of 2010, it will be a year after stopping the medicine, (Endocort).

If I eat any gluten-containing substances, I get very sick, but I watch it like a hawk. I have a lot a pain from fibromyalgia and arthritis as well, but no help with that.

I know I won’t get over this celiac disease, but, I am thankful I have come so far from where I was two years ago.

Thanks to God, My Family, Friends, and Mayo Clinic doctors to get me this far!!!!

Sincerely, Betty E. Cornine

P.S. Note!! Please remember the three steps that could save your life:
Step 1 – Blood test;
Step 2 – Endoscopy and tissue biopsy;
Step 3 – Genetic testing

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

Tags: celiac disease, patient story, Sharing Mayo Clinic

October 31st, 2014 · Leave a Comment

Gluten-Free Recipe: Apple-Fennel Slaw

By Margaret Shepard

An Apple-Fennel slaw is the perfect way to use apples freshly picked from the orchard. Fennel has a subtle licorice flavor that makes it a pleasing addition to this salad. Shop for crisp, white bulbs with bright green tops. Strip away outer leaves that are tough or browned.

Ingredients
1 medium-sized fennel bulb, thinly sliced
1 large Granny Smith apple, cored and thinly sliced
2 carrots, grated
2 tablespoons raisins
1 tablespoon olive oil
1 teaspoon sugar
1/2 cup apple juice
2 tablespoons apple cider vinegar
4 lettuce leaves
Directions
In a large bowl, combine the fennel, apple, carrots and raisins to make the slaw. Drizzle with olive oil, cover and refrigerate.

In a small saucepan, mix together the sugar and apple juice. Place over medium heat and cook until reduced to about 1/4 cup, about 10 minutes. Remove from the heat and cool. Stir in the cider vinegar. Pour the apple juice mixture over the slaw and stir to combine well. Chill thoroughly. Serve on lettuce leaves.

Recipe originally posted on mayoclinic.org.

Tags: Gluten Free, gluten free recipe, healthy living

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