By John Libonati

The article below describes low-gluten communion wafers for Roman Catholics. The wafers were tested by Dr. Allessio Fasano at the University of Maryland Celiac Disease Center to contain .01% gluten. He did mention that the machine performing the test could only test to .01% and the wafers may, in fact, contain less.

Note: The contact information for ordering low-gluten hosts is: Congregation of Benedictine Sisters of Perpetual Adoration, Altar Breads Department, 31970 State Highway P, Clyde, Missouri 64432. Phone: 1-800-223-2772.

Benedictine nuns discover way to produce low-gluten Communion hosts -------------------------------------------------------------------------------- By Dan Madden Special to the Catholic Key --------------------------------------------------------------------------------   Sister Jane Heschmeyer and Sister Lynn Marie D'Souza sort through and bag some of the low-gluten hosts at the Benedictine convent in Clyde on March 31. 

CLYDE - The small, paper-thin flakes are the texture of potato chips but not nearly as fattening. They aren't sweet or nutritious and would fail miserably in the snack-food market. Yet thousands of people across the country, and even the United States Conference of Catholic Bishops, are singing their praises.

These unexciting wafers are the result of more than a decade of trial and error by the Benedictine Sisters of Perpetual Adoration to develop an altar bread that is safe for consumption by sufferers of celiac disease, yet also remain in compliance with the strict guidelines of Canon Law. Celiac disease is a digestive disorder triggered by gluten, a protein found in wheat, barley and other grains. It affects about one in 130 Americans. The Vatican requires that Communion hosts contain some gluten, an essential ingredient in bread, but no one had discovered how to make an edible host with a low-enough gluten level to be considered safe for celiac sufferers. That is, until a little over a year ago, when a pair of Benedictine sisters, all but defeated by years of failure, did something no one had ever done.

"It was definitely the Holy Spirit at work that night," Sister Jane Heschmeyer recalls.

The sisters at Clyde, who have been making altar bread for nearly a century, began receiving pleas from celiac sufferers 15 years ago. For a brief time the sisters offered altar bread with somewhat lower gluten content, but it was still too much for most people with the disease.

Facing the legal risk of marketing bread with marginal gluten levels to celiacs, an inability to find common ground between church law and celiac sufferers, and the cost of research and production, the sisters discontinued the bread. But Sister Jane couldn't let it go. For several years she carried on alone, experimenting with recipes and conducting exhaustive research.

"I was studying the canons and gathering information," she said. "I was in touch with the celiac association, grain specialists, the USDA, doctors, lawyers, everybody I could think of."

Meanwhile the phone kept ringing. "Please keep trying," a woman would plead. "My son is having his first Communion. Is there anything you can do?" a father would ask.

Sister Jane's resolve grew stronger with each call.

The church has long said that celiac sufferers may fully receive the Eucharist in the form of wine, but even the small bit of host a celebrant drops into the wine can be harmful to many. In addition, Dennis McManus, associate director of the U.S. Bishops' Secretariat on Liturgy, noted that some people with celiac disease also suffer from a cross-allergy to wine.

The issue made national headlines in 2001 when the parents of a 5-year-old Boston girl with celiac disease left the Catholic Church after their pastor and subsequently Cardinal Bernard Law would not allow them to substitute the wheat host with a rice wafer for her First Communion.

Furthermore, the church has ruled that a priest who is unable to receive the Eucharist in both species "may not celebrate the Eucharist individually, nor may he preside at a concelebration." The church further warned that bishops must "proceed with great caution before admitting to Holy Orders those candidates unable to digest gluten or alcohol without serious harm."

There are no statistics available on how many Catholics are affected by celiac disease. But Dr. Alessio Fasano, the University of Maryland researcher whose ground-breaking study last year revealed that the disease is far more prevalent than previously thought, told The Catholic Review, newspaper of the Archdiocese of Baltimore, "If there are about 300 people in church for Mass on Sunday, then we now know that two or three of them at least are likely to have celiac."

Alessio, a Roman Catholic, found that more than 2 million Americans suffer from the disease, which he contends is often misdiagnosed. What was once considered a rare condition is twice as common as Crohn's ulcerative colitis and cystic fibrosis.

Celiac disease can be life threatening. Left untreated by a gluten-free diet, it can lead to osteoporosis, malnutrition, central and peripheral nervous system disease, pancreatic disease, internal bleeding, damage to internal organs, gynecological and fertility problems, and even some forms of cancer. It may impact mental functions, and can aggravate autism (including a common autism spectrum disorder called Asperger's syndrome), attention deficit disorder, and even schizophrenia.

Sister Jane gained a study partner in 1999. Not long after joining the postulancy, Sister Lynn Marie D'Souza happened upon Sister Jane experimenting in the kitchen and offered to help.

"She didn't have a scientific background," Sister Lynn said with as much mock hauteur as the friendly and engaging nun can muster. The young postulant, who came to Clyde with a degree in biomedical science, left the kitchen that night enthralled. She was soon assigned to the altar bread department where she fielded phone calls from celiac suffers.

There were people calling who, against doctors' orders, were taking Communion at a risk to their health.

"One woman who was 40 years old had been diagnosed and had to give up Communion," Sister Lynn said. "She asked me, 'How can I give that up?'"

Another mother called about her 18-year-old daughter who had recently received the bad news.

"My daughter is on a gluten-free diet and that's not easy," the woman told Sister Lynn. "She can't eat the same things as her friends. But she never complains about that. The only thing she complains about is that she can't receive the Eucharist."

"Imagine," Sister Lynn said. "An 18-year-old girl who is so in love with her faith and wants to practice it, and she can't." Wheat starch and water. That's what the sisters had to work with. Flour was out of the question.

But Sister Jane says experiment after experiment was a lesson in frustration: "Either the batter couldn't be stirred or it would come out like plastic."

The two nuns cooked and consumed hundreds of batches. Every one tasted terrible.

"It was like eating ." Sister Lynn said, grasping for the right words, "it was like eating starch!"

With permission from their superiors, last year the pair, who had since been joined by a novice, Kathy Becker, delved more deeply into their work, which included making a call to McManus at the USCCB liturgy office.

"They were thrilled to hear we were working on this," Sister Lynn said. "They'd been working on it too, and they sent us what they had."

But there was a catch. The bishops' eager support came with a July deadline.

With only a couple of months to go, Sister Lynn's experimenting took on more urgency, while her hope faded.

"I'd been working with two different starches," she said, holding back an inevitable smile. "One of them was a mess. It ran all over the cooking plate, and it came out like lace. With the other starch I could get something that looked like a host, but it tasted terrible and it was rubbery. I was about ready to give up."

Sister Jane joined her later that night and with utter disregard for scientific methodology, said, "Why don't we just mix the two together?"

The result was even more horrifying.

Sister Lynn declared the batter a failure. "It was sticky and horrible. We couldn't get it off the spoon or our fingers."

In frustration she globbed the epoxy-like mess onto the waffle iron, and the two began cleaning up. Before turning out the lights, Sister Lynn realized she'd forgotten to clean the gunk off the waffle iron.

"When I opened it, there was this perfect bread - well, perfect in our world," she said with a laugh. "We had tasted a lot of horrible breads."

But what they gazed upon in disbelief was a round wafer, baked evenly, with a nice texture and crispness.

"We were speechless," Sister Lynn recalled.

Like a pair of monastic mad scientists, they immediately gobbled down their creation.

"It was delicious," Sister Jane said, reliving the excitement a year later. "It was crisp, light and it tasted good. Personally, we think it tastes better than our regular altar bread."

Gluten content: .01 percent.

Safe enough, according to Fasano and other medical experts, for consumption by almost all celiac suffers. But would it pass the scrutiny of the church's hierarchy?

The answer came last July. The recipe had been approved by the Vatican, and subsequently by the U.S. bishops, as part of a new set of norms for celebrating the Eucharist. The U.S. Bishops' Committee on the Liturgy deemed the sisters' bread "the only true, low-gluten altar bread . approved for use at Mass in the United States," with a lower gluten level than a host developed recently in Italy and approved by the Vatican and the scientific committee of the Italian Celiac Association. The sisters also have applied to the U.S. government for a patent on their recipe.

Fasano called the sisters' accomplishment "very wonderful news," but added that celiac sufferers should still consult with their doctors before consuming the new hosts. In rare cases even .01 percent is still too much.

There probably won't be a financial windfall from the sales of low-gluten bread. Novice Kathy is baking about 1,600 hosts a week, although as word gets out sales are expected to increase.

But both Sister Jane and Sister Lynn said profits were never the point. What motivated them through the long nights of research, what enabled them to force down awful-tasting failure after awful-tasting failure, were the phone calls, letters and e-mails from people of faith longing for the Body of Christ in both species.

"It is such a joy," Sister Jane says of the response from celiac sufferers.

"We hear over and over again how much people appreciate what we have done, but I want to thank them," Sister Lynn said. "This has been such an inspiration. To witness their desire has increased my own desire for the Eucharist."

Recently the mother of a 12-year-old boy with celiac disease called the sisters.

Her son, she said, talked all the time about being a priest some day, but she never had the heart to tell him that door was probably closed because of something beyond his control.

"When I learned of your bread," she said, "I knew the door was open again."

----------------------- "Author Information: John Libonati, Philadelphia, PA Publisher, Glutenfreeworks.com. Editor & Publisher, Recognizing Celiac Disease. John can be reached by e-mail here."


This article talks about how different churches are responding to congregants' various allergies, including celiac disease.

Note: the catholic low-gluten communion wafers mentioned were tested at Dr. Allessio Fasano's tested at .01% gluten. (Dr. Fasano did mention the lowest level the machine could detect was .o1% and that the wafer could have contained even less.) 

The contact information for ordering low-gluten hosts is: Congregation of Benedictine Sisters of Perpetual Adoration, Altar Breads Department, 31970 State Highway P, Clyde, Missouri 64432. Phone: 1-800-223-2772.

www.baltimoresun.com/news/local/bal-te.to.allergy06jan06,0,7898965.story?coll=bal-utility-olympics [Editor: Article no longer available online]

baltimoresun.com

Allergies lead churches to new practices By Jill Rosen

Sun reporter

January 6, 2008

 The Rev. Bill Miller-Zurell was recently presiding at Communion, moving from congregant to congregant, offering the body, offering the blood, until he got to a little boy who, seeing the piece of bread, stopped the pastor short.

"He asked me if there were any nuts in it," said Miller-Zurell, who leads New Hope Lutheran Church in Columbia. "His mom, who was standing behind him, made him. And he only took it after I assured him that there were no nuts."

In an increasingly susceptible world, where more and more people are realizing that things like nuts and wheat and even certain pungent scents can make them quite sick, religious organizations are reconsidering the most time-honored of traditions.

Communion wafers are now available in rice and soy. Religious supply stores are offering hypo-allergenic incense. Churches are banning cologne and cutting way back on Easter lilies. Fresh pine boughs for the holidays are often out. A group of nuns in Missouri have invented a host with only a trace of wheat so that the gluten-sensitive could digest it.

"I've just been amazed - there's more and more and more," Miller-Zurrell said. "I suspect it's an increase in allergies, and certainly an awareness on my part."

According to the Centers for Disease Control and Prevention, as many as 8 percent of children suffer from a food allergy. And every year, the organization reports, allergic reactions are responsible for 30,000 cases of anaphylaxis, 2,000 hospitalizations and 150 deaths.

The Rev. Sue Montgomery, a Pennsylvania pastor who works on a national level to help the Presbyterian Church become more accessible for disabled parishioners, insists that as more people get diagnoses of allergies, the clergy must bend to meet their needs. "The invitation to the Lord's Table is for everyone," she likes to tell people, "even those with food allergies."

Montgomery says religious organizations must provide for worshipers with certain dietary needs, just as they build ramps for those in wheelchairs or offer Braille Bibles for the blind.

"We're moving toward seeing disabilities as diversity rather than an aberration or something abnormal that needs to be cured or fixed," she said. "The church is just beginning to wake up to that."

Just a few years ago, national media attention turned to the Roman Catholic Church after a couple of dioceses refused to offer First Communion to girls suffering from celiac disease - an inability to tolerate wheat. Under orders from the Vatican, the churches, one in Massachusetts, the other in New Jersey, would not consider using soy or rice wafers, insisting that only the traditional wheat host was legitimate.

The problem seemed solved when Benedictine nuns in Missouri developed a wheat wafer with only trace levels of gluten - a wafer that has passed muster with both the U.S. Conference of Catholic Bishops and those with celiac disease.

But even with the new wafer, Catholics with food allergies still feel somewhat ostracized, according to Chris Spreitzer, who founded the Catholic Celiac Society.

The New York woman, whose husband and three daughters have celiac disease, said during a holiday service in Orange County, Calif., last month, the priest stopped the ceremony to reprimand her husband and the girls for joining the line for wine without having taken the bread.

"My husband had to stand there and explain," she said. The priest only relented when they explained that they had celiac. "It kind of made a small uproar. You don't want to always be the person standing out in the crowd and making a small scene."

Because Spreitzer has spent considerable time teaching her girls that no gluten is safe, she doesn't like the idea of a low-gluten wafer exception.

"I tried to teach them that no gluten is safe, and I have the church on the other hand saying you can have this wheat," she said. "We've chosen not to use them because it sends a mixed message to the children."

When Bruce Watson told the leaders at Baltimore's Cathedral of the Incarnation, which is Episcopal, that his daughter, Rosemary, will swell up and wheeze if she eats wheat, they had no problem allowing her to take a rice wafer for communion. The church, which notes the availability of the alternative wafers in its bulletin, has since discovered other parishioners with the same problem.

"We're trying to figure out what would make sense for her, to make sure she's fully included," said Jan Hamill, who is canon for Christian formation at the cathedral.

The Cathedral of the Incarnation has also all but eliminated incense from services - only bringing it out for major holidays. And then, she says, the sensitive worshipers know better than to sit anywhere near the center aisle.

In some churches, the institutional memory is scented with candles, oils and the heady aromas of frankincense and myrrh. But they're having to make changes because the heavy scents can cause people with perfume allergies to sneeze, itch and even experience trouble breathing.

At the Religious Supply Center in Davenport, Iowa, owner Mark Gould says he's noticed more and more requests from pastors for subtle incense, something with less potency.

"We actually get calls where they ask for smokeless incense," he said, "Which is kind of a funny one, if you think about it, because it doesn't exist. We do, however, have something where you can still visualize the smoke but it's not - and I don't know if 'offensive' is the word - it's not as strong a smell."

Baltimore's Beth Am Synagogue publishes a note every week in the Shabbat program asking people to hold off on cologne, perfume and aftershave. It also postS notes reminding people in the men's and women's restrooms. If someone should forget, it often falls on Executive Director Henry Feller to provide a tap on the shoulder.

"As gently and kindly as I can, I'll mention to them that we have some people who are highly allergic," Feller said.

The synagogue only orders non-fragrant or minimally fragrant flowers for the bema, and, after an unfortunate incident with citrus spray, keeps its cleaning products scent-free as well. Feller has gotten many queries from other congregants on how Beth Am drafted its policy.

At New Hope Lutheran, Miller-Zurell couldn't have been more surprised last Easter to find himself - after years with no problems - having a bad reaction to the lilies, dandelions and hydrangeas decorating the church.

"My voice started to go," he said. "It's very colorful, but my goodness, it can be overwhelming,"

Now the church will be more careful with the flowers - they already did away with the natural pine boughs and trees for Christmas.

"Yes, I know," he said glumly. "I grew up with the smell. And you know smell is one of the most wonderful senses for bringing back memories."

New Hope member Pat Wheeler, whose 14-year-old daughter, Sarah, has celiac disease, said in the seven years since the diagnosis, the disease has become better known and more accepted.

And she said the church's understanding and flexibility haVE been "fantastic."

"It's very important to [Sarah]," Wheeler said. "She needs to do what everyone else does and practice her faith."

jill.rosen@baltsun.com

Copyright © 2008, The Baltimore Sun

Acid reflux affects millions of people every day.

Heartburn is the major symptom of acid in the esophagus, characterized by burning discomfort behind the breastbone (sternum). Findings in gastro-esophageal reflux disease (GERD)  include esophagitis (reflux esophagitis) — inflammatory changes in the esophageal lining (mucosa) —, strictures, difficulty swallowing (dysphagia), and chronic chest pain. Patients may have only one of those symptoms. Typical GERD symptoms include cough, hoarseness, voice changes, chronic ear ache, burning chest pains, nausea or sinusitis. GERD complications include stricture formation, Barrett's esophagus, esophageal spasms, esophageal ulcers, and possibly even lead to esophageal cancer, especially in adults over 60 years old.

Occasional heartburn is common but does not necessarily mean one has GERD. Patients with heartburn symptoms more than once a week are at risk of developing GERD. A hiatal hernia is usually asymptomatic, but the presence of a hiatal hernia is a risk factor for developing GERD.

Here is some interesting information about acid reflux drugs. In 2006, over 100 million prescriptions for proton pump inhibitors (acid reflux drugs) were filled at a cost of $13.6 billion.  It is true that acid reflux drugs definitely help in the short term.  They reduce acid.

Unfortunately, the more powerful acid blockers (omeprazole, esomeprezole) can interfere with calcium adsorption and can aggravate preexisting hypocalcaemia and hypomagnesemia which are more common in celiac disease. [1]

They can also cause problems for people with cirrhosis. Use of proton pump inhibitors (PPIs) in patients with cirrhosis was associated with a risk of spontaneous bacterial peritonitis and Clostridium difficile-associated disease, according to two retrospective studies. [2]

Finally, long term use can also lead to Vitamin B12 deficiency. Vitamin B12 deficiency is already a common deficiency among people with celiac disease. The medications work by blocking acid secretion from the parietal cells of the stomach, but these cells also make a substance called intrinsic factor, which is critical for vitamin B12 absorption. Because proton-pump inhibitors such as Prilosec also reduce intrinsic factor secretion, long-term use can lead to a vitamin B12 deficiency. [3] 

Vitamin B12 deficiency is serious because it can lead to neurologic disorders. The neurologic symptoms of vitamin B12 deficiency include numbness and tingling of the arms and, more commonly, the legs, difficulty walking, memory loss, disorientation, and dementia with or without mood changes. Although the progression of neurologic complications is generally gradual, such symptoms are not always reversible with treatment of vitamin B12 deficiency, especially if they have been present for a long time. [4]  

Here are some things what work well for acid reflux and won't destroy your health:

Dietary Changes:

1) Maintain a 100% strict gluten-free diet.  The immune reaction to gluten starts in the mouth and works all the way through the gastrointestinal tract, so avoid it. 

2) Doctors also now suggest that heartburn sufferers keep a daily food diary, so they are better able to see what food triggers are present in their day-to-day life. Once a list of common triggers have been found, begin eliminating foods one by one. Common heartburn triggers include chocolate, fried and fatty foods, and spices.  [5]

3) While suffering heartburn, you're advised to refrain from consuming alcohol, caffeine, over-the-counter pain relievers, and other stimulants, which change the acidity of the stomach, and irritate the lining of the stomach further. [5]

4) Decrease sugar intake.  Sugar causes acid reflux in some individuals. [5]5) Increase fiber. Consuming more fiber nutrient foods is another natural way to alleviate future suffering. Bulk foods help to absorb excess acid and gas, and allow your body to rid itself of toxins more quickly. For those who respond poorly to high fiber vegetables, fiber pills and beverages are an easy alternative. [5]

6) Drink more water. The more water you drink, the less likely you are to suffer the pains of heartburn. Drinking at least 8-glasses of water each day will rid the body of toxins and allow your body to expel acid naturally.

Remedies:

Here are some quick home remedies that can help. 

1) Baking soda - take a 1/2 teaspoon of baking soda and mix with 4 oz. of water.  Drink it.  Baking soda is a base and counteracts the acid almost immediately.  It also has another benefit in that it cuts the reaction of the gluten proteins that cause the reflux in the first place. (If you accidentally ingested gluten.) It works quickly and is about as cheap a remedy as you'll find.

2) Alka Seltzer Gold - this is gluten-free and works quickly. 

3) Apple cider vinegar - this remedy was suggested Alisa Weeks,  a member of the Knoxville Celiac Support Group. "We use the apple cider vinegar with great success. We take about a teaspoonful with some juice."

4) Food enzymes - which help to speed the digestive process often eliminate heartburn altogether. Papaya enzymes are sold in chewable capsule form, and are taken immediately following a meal with a full glass of water. Both ginger and digestive enzymes are not medically proven to help with symptoms. [5]

Sources:

[1] Robb-Nicholson C (2007). "By the way, doctor. I heard that taking a proton-pump inhibitor could cause hip fractures. I've been taking 20 mg of Prilosec every day for a year. Should I be concerned?". Harvard women's health watch 14 (7): 8. PMID 17396273.

[2] Bajaj JS, et al "Proton Pump Inhibitor Use is Associated with a High Risk of Spontaneous Bacterial Peritonitis" Abstract 740 presented Nov. 4.

[3] http://www.everydayhealth.com/publicsite/index.aspx?puid=f0ed5fe5-034e-4196-997b-f976c293a99c&p=1

[4] http://lpi.oregonstate.edu/infocenter/vitamins/vitaminB12/

[5] http://heartburn.about.com/gi/dynamic/offsite.htm?zi=1/XJ/Ya&sdn=heartburn&cdn=health&tm=12&gps=89_111_1020_570&f=00&su=p284.8.150.ip_&tt=14&bt=0&bts=0&zu=http%3A//nhnh.essortment.com/heartburnhomer_rwel.htm

John Libonati

Bone Mineral Density and Celiac Disease in Women

January 4th, 2008 by John Libonati

The article below describes a study showing if a woman enters menopause with a low bone mineral density, the risk is 25% to develop fractures compared to 9% who had normal bone mineral density. This is a significant and important reason for women with celiac disease to: 

1) Keep a strict gluten-free diet to be able to absorb calcium, vitamin D and other nutrients vital to bone health,   2) Influence disinterested relatives to get tested, and 

3) Get a baseline bone mineral density (BMD) test with follow-up for the appropriate supplementation. Bone Density Tests Do Predict Women's Fracture Risk Largest, longest study ever supports screening and prevention of osteoporosis

By Amanda GardnerPosted 12/18/07

TUESDAY, Dec. 18 (HealthDay News) -- One bone mineral density test can accurately predict a woman's chance of spinal fractures 15 years down the line, new research shows.

And, according to the largest and longest prospective study of osteoporosis ever, women who had a spinal fracture at the beginning of the study had four times the risk of sustaining another fracture later on.

The bottom line: "Women need to talk to their doctors about the risk of osteoporosis," according to Jane Cauley, lead author of the study and professor of epidemiology at the University of Pittsburgh Graduate School of Public Health.

Her team published the findings in the Dec. 19 issue of the Journal of the American Medical Association.

"I agree with the guidelines that all women after the age of 65 have bone density tests, and Medicare will pay for that," Cauley said. "Women who are postmenopausal, 50 to 64 years of age, should consider having a bone density test if they have other risk factors for osteoporosis or if they want to know what their bone density is before they consider any other treatment."

The findings don't change current standard practice, experts said, and they don't change the basic message to women: Don't ignore bone health, especially in middle and old age.

"The only really major advance here is that it's a longer term study. Mostly studies are five years typically. This one went out 15 years," said Paul Brandt, associate professor of neuroscience and experimental therapeutics at Texas A&M Health Science Center College of Medicine in College Station. "Women need to get their bone mineral density tested after they start menopause and if they stay on hormone replacement therapy or an anti-osteoporotic treatment." he said.

Postmenopausal women are particularly vulnerable to fractures resulting from osteoporosis, a degenerative weakening of the bones. Some 10 million Americans, including one in five American women over the age of 50, suffer from osteoporosis, which is the most common type of bone disease.

Spinal fractures are the most common type of fracture resulting from osteoporosis, affecting 35 percent to 50 percent of women over 50 (about 700,000 vertebral fractures annually in the

United States). But many, if not most, of these fractures go undetected. "Osteoporosis is sometimes called the silent thief," Cauley said. "It basically robs the skeleton of strength and resources, and women don't really know about it. About 75 percent of all spine fractures actually occur silently."

"Identifying risk factors for spine fractures is less well developed. You have to systematically look for them by repeated X-rays," Cauley continued.

The findings from this study are based on bone mineral density data from 2,300 women over the age of 65 who enrolled in the Study of Osteoporotic Fractures (SOF), initiated in 1986.

After 15 years of follow-up, it was evident that 25 percent of women who had low BMD at the beginning of the study developed fractures of the spine, compared with only 9 percent of women with normal BMD.

"It was pretty much a strong gradient of risk," Cauley explained. "If you had normal bone density when you entered and did not have an [existing] fracture, the risk of having a new spine fracture was about 9 percent, compared to a risk of 56 percent in women who had osteoporosis and who had an existing fracture. So, the range of risk varied dramatically depending on bone density and previous spine fractures."

According to Brandt, one interesting finding from the study is that a previous vertebral fracture topped even bone mineral density as a predictor for future fracture.

This indicates that women with an existing vertebral fracture should be treated for osteoporosis regardless of their BMD, the authors reported.

"People think osteoporosis is an inevitable consequence of aging, but it is preventable and treatable," she said.

More information There's more on age-linked bone loss at the U.S. National Library of Medicine. Copyright © 2007 ScoutNews, LLC. All rights reserved.                  

John Libonati

Book Review by Gastroenterology Nursing!

December 21st, 2007 by John Libonati

Recognizing Celiac Disease: Signs, Symptoms, Associated Disorders & Complications by C.J. Libonati (2007).

Fort Washington, PA: Gluten Free Works Publishing.  www.recognizingceliacdisease.com

This book is a first for author Cleo J. Libonati. A registered nurse with first-hand knowledge of celiac disease, Libonati takes the reader on a journey that educates and enlightens. This self-published book has a wealth of information useful for those afflicted with celiac disease as well as the healthcare professionals caring for them.

The topic of the book is important to all because of the prevalence of celiac disease in the United States. Prevalence studies conducted in the United States demonstrate that 1 in 133 Americans have celiac disease, amounting to a staggering 3 million Americans afflicted with the disorder, yet few are diagnosed. Complicating this picture is the lack of education and general knowledge of the disease among the public, health agencies, and healthcare professionals. In the introduction, Libonati notes that only 48 of the 6,276 papers published on celiac disease in the last 30 years were published in the United States.

The book reviews the pathophysiology, symptoms, manifestations, complications, associated disorders, diagnosis, and treatment of the disease. Written in clear concise language that both the layperson and health professional can understand, the book successfully integrates the research data on celiac disease into a useful resource. The print, format, tables, illustrations, and careful citation of research data along with the inclusion of the final statement from the June 2004 National Institutes of Health Consensus Development Conference on Celiac Disease make this text an easy to read resource for those wishing to further their education on celiac disease.

The message of the book is especially important for all health professionals specializing in gastroenterology. Although signs, symptoms, and presentation of celiac disease can be different in each individual afflicted, the common denominator is damage to the small bowel. This book provides a useful resource for every health professional associated with a gastroenterology practice and would be a valuable addition to office resources on celiac disease.

Recognizing Celiac Disease is very well organized and contains two sections. The first section of the book includes three chapters. Beginning with a discussion of gluten as the environmental trigger for celiac disease, the book takes the reader on a step-by-step journey into understanding the origin, pathophysiology, and symptoms of celiac disease. From definition of the disease to signs, symptoms, diagnostic criteria, and treatment of celiac disease, each chapter gives in-depth, up-to-date information on all aspects of each topic. Of particular interest to gastroenterology health professionals is an overview of the workings of the gastrointestinal tract along with the pathophysiology celiac disease inflicts on the gastrointestinal system. This section is written in a manner that will assist any reader in understanding the multiple presentations and physical manifestations of the disease. Also included in this section are three appendices; “Unsafe Foods and Ingredients,” “Gluten-Free Diet Self-Management Three Step Process,” and “Sample Foods Commonly Allowed and Not Allowed on a GF Diet.” Each appendix is easy to read and understand. Although in-depth resources in themselves, the chapters and appendices include citations of research, articles, and resources utilized in creating each section of the book, providing the reader tools to further his or her knowledge if they so desire. This section also contains a glossary to assist readers unfamiliar with the terminology used in discussions of disease processes and their epidemiology.

The second section of the book is unique in that it contains two tables outlining an extensive literature review done by the author. An easy to read explanation on how to use this section of the book assists the reader to fully utilize the extensive amount of information presented in the tables. The first table lists nutritional deficiencies of celiac disease and the second table lists the signs, symptoms, associated disorders, and complications of celiac disease. Both tables are extremely helpful, providing extensive information on the typical and atypical signs and symptoms of the disease. Included in each table is information identifying associated disorders, complications, and whether these improve or do not improve on the gluten-free diet. The tables are a rich resource to understanding the nuances of celiac disease. Although the tables themselves provide a tremendous amount of information, the citations provided in the tables lead the reader to an even larger data base of information regarding all aspects of celiac disease.

Finally, the book contains an extensive reference list and index. The reference list is organized by the section of the book in which the sources are cited, and the index is well organized and easily assists readers in finding their desired topic.

Recognizing Celiac Disease: Signs, Symptoms, Associated Disorders & Complications certainly lives up to the title. Libonati clearly outlines the extent of the disease and the need for recognizing, diagnosing, and treating celiac disease in the United States. Her book educates the reader not only about the disease process, but addresses treating and recognizing nutritional deficiencies, associated disorders, and the many complications of the disease. Recognizing Celiac Disease should be on the shelf of every family affected by celiac disease as well as the health professionals caring for them. -----------------------------------------------

© The Society of Gastroenterology Nurses & Associates 2007. All Rights Reserved. Volume 30(5), September/October 2007, p 387–388 Recognizing Celiac Disease: Signs, Symptoms, Associated Disorders & Complications by C.J. Libonati (2007). Fort Washington, PA: Gluten Free Works Publishing.

[Department: Book Review] Gainer, Cheryl L. MSN, CNM, RN

Cheryl L. Gainer, MSN, CNM, RN, is Clinical Instructor, The University of Texas at Arlington, School ofNursing,Arlington, Texas.

John Libonati

Non-alcoholic Fatty Liver Disease and Gluten

November 16th, 2007 by John Libonati

non alcoholic cirrhosis fatty liver celiac disease gluten This is super important for anyone with fatty liver disease!

While we were at Columbia University's Topics in Gastroenterology, Dr. Steven Lobritto talked about cirrhosis of the liver and how he has actually seen people who were on the liver transplant list heal enough to be taken off once they started a gluten-free diet. That's right.  People who needed liver transplants - their liver's were basically done for - healed!

Non-alcoholic fatty liver is a non-inflammatory hepatic (liver) disorder characterized by degenerative changes in the liver secondary to excessive accumulation of lipid in hepatocytes.

According to research we found for our book, "Recognizing Celiac Disease" 3.4% of people with non-alcoholic fatty liver disease have SILENT Celiac Disease. That means they don't have symptoms.  Most patients DO NOT have gastrointestinal symptoms.

The good news is that studies showed liver enzymes can normalize after 6 months on a gluten-free diet. If you or your family members have non-alcoholic fatty liver (cirrhosis), but have not been tested for celiac disease, get tested and give them this information so they can get tested.  And if they test negative, try the diet anyway because we've seen time and time again that the test are NOT 100% accurate.

 

-------------------- Author Information: John Libonati, Philadelphia, PA Publisher, Glutenfreeworks.com. Editor & Publisher, Recognizing Celiac Disease. John can be reached by e-mail here.

John Libonati

Hello World!!!

November 16th, 2007 by John Libonati

Hi there and welcome to the brand new Glutenfreeworks blog.  Just like the rest of the website, we will be focusing on all things gluten and gluten-free related.  New info, studies and news is coming out all the time now. We have TONS of info to post so check back often.

 -John & Cleo

John Libonati

Gluten Free Works Vendor Fair

January 18th, 2005 by John Libonati

Platinum

Better Batter

Better Batter

 

 

 

John Libonati

Test 2

January 17th, 2005 by John Libonati

John Libonati

Test

January 17th, 2005 by John Libonati

This is so cool. Click here.