Bovine Beta Casein Enteropathy

The following questions concern whether villous atrophy can be caused by milk and whether anemia can result from milk ingestion. The answer is yes: bovine beta casein enteropathy can cause both. See full explanation below.

Question:Does anyone know can a deficiency in lactase enzyme cause the villi to be blunted? My 3 year old son just had an endoscopy and it showed the villi are blunted.

My son has a lactase deficiency and has been gluten free for 18 months. We took him off lactose for the first 6 months after being diagnosed but then added it back and he seemed fine for 6 months.

So I am hoping maybe the fact that he was drinking a lot of milk caused the villi to be blunted and not ingesting any gluten?

Also, can that cause anemia?

My son is also slightly anemic. But we are very strict with his diet and I am pretty sure he is not getting any gluten ( i know its possible but I don’t think so… his diet hasn’t changed..)

Celiac antibody blood tests indicate he is not getting gluten?

So I am wondering if the lactose could be causing the villi to be blunted and the anemia???

Thanks,
S

Answer:
Dear S,

The most common cause of villous atrophy in people with celiac disease is unintentional gluten ingestion. This answer assumes no gluten is being ingested.

Cow dairy can cause an enteropathy similar to celiac disease. It is called Bovine Beta Casein Enteropathy. It acts like celiac disease, causing inflammation leading to villous blunting. The milk protein elicits the antibody reaction just like gluten does in celiac disease.

The resulting villous blunting would explain lactose intolerance, as the lactase enzymes needed to digest lactose are produced and release near the tips of the villi. If the villi are blunted, no lactase is being produced and milke digestion does not occur.

Bovine beta casein enteropathy is marked by diarrhea, failure to thrive, vomiting, atopic eczema and recurrent respiratory infections. It causes malabsorption of nutrients, just like celiac disease, so it can lead to nutrient deficiencies including anemia. 12% of those with bovine beta casein enteropathy are found to have celiac disease.

-John Libonati

[Editor’s Note: Article originally published April 20, 2009]

Source: Gluten Free Works Treatment Guide: Bovine Beta Casein Enteropathy.