Tag Archives: Celiac disease

Shared Genes in Type 1 Diabetes and Celiac Disease

A 2008 study provides more evidence that there is a link between celiac disease and gluten. This article in Scientific American reviews the study.

Diabetes and celiac disease: A Genetic Connection
Patients with type 1 diabetes have been known to be more prone to another autoimmune disorder, celiac disease, in which gluten in wheat, rye and barley triggers an immune response that damages the small intestine or gut. Now there’s evidence that the two diseases have a genetic link: they share at least seven chromosome regions.

The discovery, published in this week’s New England Journal of Medicine, indicates that both diseases may be triggered by similar genetic and environmental mechanisms, such as certain foods, that cause patients’ immune systems to become overactive and destroy healthy instead of infected tissue. Previous research has found that celiac disease is five to 10 times more common in people with type 1 diabetes than in the general population, an editorial accompanying the study notes.

“These findings suggest common mechanisms causing both celiac and type 1 diabetes – we did not expect to see this very high degree of shared genetic risk factors,” said study co-author David van Heel, a gastrointestinal geneticist at Barts and the London School of Medicine and Dentistry.

Van Heel and his colleagues studied genetic material or DNA from about 20,000 people, half of them healthy, nearly half with type 1 diabetes, and 2,000 with celiac disease. The overlapping genetic variants occurred on regions of chromosomes (parts of cells that carry genetic code) that are believed to regulate the gut’s immune system, the BBC notes.

Type 1 diabetes occurs when a person’s immune system mistakenly attacks healthy beta cells in the pancreas that produce the hormone insulin, which is needed to convert glucose into energy. In celiac disease, a similar attack occurs on the small intestine when sufferers eat gluten-rich grains, causing inflammation in the gut that can lead to bloating, abdominal pain, nausea, constipation, diarrhea, fatigue, anemia, headaches, weight loss and failure to thrive in children. Whereas diabetes 1 patients must inject insulin daily to make up for their deficiency, people with celiac disease can avoid damage and symptoms by sticking to a gluten-free diet.

“The finding raises the question of whether eating cereal and other gluten products might trigger type 1 diabetes by altering the function of the gut and its interaction with the pancreas, the authors write. But Robert Goldstein, chief scientific officer of the Juvenile Diabetes Research Foundation, which helped fund the study, says it would be premature to assume from this study that gluten is also a diabetes trigger.

“I fear the newspaper headlines in the popular press will read like, ‘Eating wheat will cause type 1 diabetes,’” Goldstein tells us. “The presence or absence of these associations has to be linked to some biological consequence” for a person’s health.

Article Source: http://www.sciam.com/blog/60-second-science/post.cfm?id=diabetes-and-celiac-disease-a-genet-2008-12-11

*UK Study Source: Shared and Distinct Genetic Variants in Type 1 Diabetes and Celiac Disease, New England Journal of Medicine. http://content.nejm.org/cgi/content/full/NEJMoa0807917

Alba Therapeutics Announces Enrollment of Its First European Patient in Global Phase IIb Study

 

PRESS RELEASE
Milestone Marks the First Time a European Patient with Active Celiac Disease has Enrolled in a Clinical Trial for an Investigational Medication from Alba Therapeutics
Last update: 8:22 p.m. EST Nov. 11, 2008
BALTIMORE, Nov 11, 2008 /PRNewswire via COMTEX/ —

Alba Therapeutics Corporation announced today that for the first time, a European patient with active celiac disease has been enrolled in its clinical trial to investigate a treatment for the disease. Alba has enrolled and randomized the newly diagnosed patient from Spain in an eight-week Phase IIb trial with oral larazotide acetate, a tight junction regulator, for the treatment of patients with active celiac disease (CD). The global multi-center, randomized, double-blind, placebo-controlled study will evaluate the clinical and histological efficacy, safety and tolerability of larazotide acetate in 106 active CD subjects adhering to a gluten-free diet, while assessing improvement in the clinical signs and symptoms of celiac disease.

“These are decisive times for our desire to one day be able to offer our celiac patients a treatment that allows them to live more normal lives,” said Dr. Gemma Castillejo, MD, a pediatric gastroenterologist and principal investigator in the study. Dr. Castillejo, a leading European celiac expert from the Sant Joan de Reus University Hospital in Reus, Spain added, “I believe this clinical trial has the potential to be a turning point in the search for treatments for celiac disease.”
“This is a major milestone for the celiac community in Europe,” stated Francisco Leon, MD, PhD, Vice President, Clinical Development and Medical Affairs of Alba. “This is Alba’s sixth human trial with larazotide acetate, and we are excited to be advancing our investigational program for larazotide acetate in this important region of the world.”
About Celiac Disease
Celiac disease is an inherited autoimmune disorder where gluten has been identified as the environmental trigger of the disease. Gluten is an ingested protein found in wheat, barley and rye. Gluten is broken down into gliadin which can pass through the intestinal epithelial barrier during times of increased intestinal permeability. The ingestion of gluten causes an immune response which triggers an inflammatory reaction in the small intestine. This then causes damage to the villi in the small intestine and can lead to total villous atrophy in celiac disease. This results in varying symptoms such as fatigue, skin rash, anemia, fertility issues, joint pain, weight loss, pale sores inside the mouth, tooth discoloration or loss of enamel, depression, chronic diarrhea or constipation, gas and abdominal pain. The immunology and nutritional abnormalities in celiac disease can potentially result in long- term complications such as osteoporosis, refractory sprue, small intestinal cancer, and lymphoma.
Celiac disease is a growing public health concern, affecting approximately 3 million people in the United States and over 6.5 million people worldwide. The only current management of celiac disease is complete elimination of gluten from the diet, which can be very difficult to implement in practice. Additionally, the response to the gluten-free diet is poor in up to 30% of patients, and dietary nonadherence is the chief cause of persistent or recurrent symptoms.(1)
(1) Green, P, and Cellier, C, Review Article,
 Medical Progress, Celiac Disease, N ENGL J MED
 2007;357:1731-43
About “Larazotide Acetate”
Larazotide acetate is an experimental medicine and a tight junction regulator that acts locally by inhibiting the opening of tight junctions in epithelial cells lining the small intestine. In celiac disease, gluten crosses the epithelial barrier and stimulates the immune system, leading to cytokine release, gut inflammation, and opening of tight junctions. This leads to increased paracellular permeability, increased entry of gluten and the establishment of an intestinal permeability-inflammation loop. Larazotide acetate inhibits tight junction opening triggered by both gluten and inflammatory cytokines, thus reducing uptake of gluten. Larazotide acetate disrupts the intestinal permeability-inflammation loop, and reduces symptoms associated with celiac disease. Larazotide acetate is orally formulated, has been granted “Fast Track” designation by the U.S. Food and Drug Administration for the treatment of celiac disease, and is also being evaluated for the treatment of Crohn’s Disease.

For more information about Alba’s clinical trials, please visit the www.clinicaltrials.gov web site and search for Alba Therapeutics.

About Alba
Alba Therapeutics Corporation is a privately held, clinical-stage biopharmaceutical company focused on the discovery, development, and commercialization of therapies to treat autoimmune and inflammatory diseases and is located in Baltimore, Maryland. Alba’s technology platform is based upon a key pathway that regulates the assembly and disassembly of tight junctions in cell barriers throughout the body. As a result of its unique technology platform, Alba is a leader in mucosal biology and has developed a pipeline of innovative therapeutic candidates that has the potential to modify the course of disease and significantly improve upon existing treatments for a wide range of diseases such as celiac disease, Crohn’s disease, and Asthma/COPD or acute lung injury.
    Media: Mariesa Kemble
    Sam Brown Communications
    608-850-4745
    kemblem@aol.com 

    Corporate: Wendy Perrow, MBA
    Alba Therapeutics Corporation
    410-878-9850
    info@albatherapeutics.com
    http://www.albatherapeutics.com
----------------------
Author Information: John Libonati, Philadelphia, PA
Publisher, Glutenfreeworks.com.
Editor & Publisher, Recognizing Celiac Disease.
John can be reached by e-mail here.

Ultimate Guide to Gluten-Free Living – Free Giveaway Until July 30th

The Celiac Disease Center at Columbia University is sending a free copy of their newly revised Ultimate Guide to Gluten-Free Living to everyone on their contact list as of July 30, 2008.  To receive a copy, please email your complete contact information (name, address, phone, fax, email) to cb2280@columbia.edu.  The guide will be mailed after July 30, 2008.

The Celiac Disease Center at Columbia University was established within the Department of Medicine at Columbia University in 2001.  Its mission: to redefine the future of celiac disease and treatment on an ongoing basis, through continuing advances in research, patient care, and physician and public education.

Under the guidance of Peter Green, MD, one of a few recognized experts on celiac disease in the United States, the Center has become world-renowned for its services and programs and is one of the first medical school based centers in the United States dedicated to the treatment and study of celiac disease. The Center is diagnosing and treating more than 2600 patients annually from around the world.  Additional information is available online at www.celiacdiseasecenter.org.

Tell Cynthia Gluten Free Works sent you!  :)

-John

John Libonati, Editor
john.libonati@glutenfreeworks.com

Investigation of gluten sensitivity requires anti-gliadin antibody testing.

The news release below is timely because anti-gliadin antibody blood tests are losing ground while the reality of gluten sensitivity looms far larger than is now appreciated by many doctors!  These blood tests are absolutely necessary to investigate health problems caused by gluten itself, yet they are being dismissed by doctors who look only to diagnosing celiac disease.

Positive anti-gliadin antibody tests show undigested gluten peptides in the bloodstream.  This abnormal finding tells the story that gluten has passed through the tight barrier defenses of the small intestinal lining into the body where it can wreak havoc, with or without celiac disease.  Gluten is a food protein in wheat, barley, rye and oats.

In screening for celiac disease, an inherited immune response to gluten entering the small intestinal lining, doctors rely on the celiac specific antibody tests, anti-endomysium and anti-tissue transglutaminase.  However, the investigation to find these auto-antibodies must not exclude the anti-gliadin antibodies. 

Doctors Slow To Recognise Gluten Harm.” Dr. Rodney Ford, Leading New Zealand Paediatrician And Allergist Challenges Medical Stalwarts With Revolutionary Gluten Thinking

There is more to gluten problems than just coeliac disease. Gluten sensitivity is ten times more prevalent than celiac disease in New Zealand and mostly undiagnosed. This is the message that Christchurch-based paediatrician, allergist and author, Doctor Rodney Ford wants to get across to the public and the ever conservative medical fraternity.

The practice of medicine is restricted to the knowledge, experience, attitudes and politics of the society it functions in. Medicine is an inexact but evolving science, thus current standard medical practices are often disproved. The validity of medical opinion, long held to be the gold standard of diagnosis and treatment, are constantly challenged. This is a healthy dynamic, one that enables the pursuit of excellence and the evolution of better forms of practice, resulting in better outcomes for patients. Why, then asks Dr Ford, is there such resistance to his new Gluten Syndrome hypothesis recently published in a book and supported by years of clinical experience and research.

In the absence of coeliac disease, his latest research shows that the simple gluten test (IgG-gliadin antibody) is a sensitive indicator to detect those people who get sick eating gluten but who have tested negative to Celiac Disease. However, this test is rarely ordered by general practitioners or specialists. He says “This is because of an illogical rejection of gluten sensitivity as a valid diagnosis. Ignoring gluten flies in the face of all of the evidence and is also alienating doctors from their patients.”

Picture this, if you will: a six year old girl, Elizabeth, small for her age, a distended stomach, gas and suffering from gastric reflux. Her teachers reported a lack of attention at school and early learning problems. Elizabeth had been thoroughly investigated by the medical profession: blood tests, bowel biopsies, colonoscopy, endoscopy. Celiac Disease had been ruled out, various medications had been tried and doctors had started to question her mother’s parenting skills. Elizabeth’s parents had gone beyond frustration and fear for their child, they were at the point of desperation.

This is a common story in Dr Ford’s practice. It is also one of the many success stories he has to share. After seeing Dr Ford, a positive IgG-gliadin antibody test and being put on a gluten free diet, Elizabeth improved within a few days. Within weeks she made a remarkable recovery and was in essence cured. Gluten was no longer a choice for her and accidental intake still causes her a reoccurrence of symptoms. Adhering to a gluten free diet has enabled Elizabeth to grow into the healthy, happy and successful young woman that she is today.

Common stories such as this, along with the increasing research and evidence of gluten based harm, should be enough to spur the medical profession into action in an effort to save the current generation of children from the long term health, social and financial consequences of what is an easily diagnosed and treatable condition.

The shocking truth is that this terrible scourge of gluten is being ignored by most medical practitioners. Even worse, the blood tests that can diagnose it are being abandoned by many medical laboratories. For instance, Medlab Diagnostics in Auckland no longer offers gliadin antibody tests.

The medical professions reluctance to act on the gluten problem is costing New Zealand billions of dollars each year with long term and far reaching consequences. From a dollars and cents point of view it makes no economic sense. From a patient care point of view it is bordering on negligence.

Source: Scoop Independent News, New Zealand, Thursday, 19 June 2008, 9:49 am
You can find this news release at http://www.scoop.co.nz/stories/GE0806/S00059.htm

Everyone on a Gluten Free Diet?

The below article by Nadine Grzeskowiak is a good explanation of why the gluten-free diet can work for anyone and everyone and pitfalls of the celiac tests.  Medical experts speak of the gluten-free diet as if it is something strange, yet most unprocessed foods you cook yourself are naturally gluten free.  All meats, seafood, fruits, vegetables, nuts, legumes, dairy (unless gluten was added to them), corn, rice and other grains,(besides wheat, barley, rye or oats), naturally do not contain harmful gluten.  Wheat, barley, rye and oats don’t contain any nutrients you cannot get in other foods, so what is the big deal with not eating them?Nadine’s article is excellent.  The only thing I would add is if you do eliminate the gluten grains of wheat, barley, rye and oats and feel better within two weeks, get yourself tested for celiac disease.  A positive diagnosis makes dealing with healthcare providers much easier.  That said, if it comes back negative but you feel better being gluten-free then eliminate gluten from your diet and be healthy.You can find Nadine’s blog article at http://glutenfreern.com:80/everyone-on-a-gluten-free-diet/-John Libonati, Editor Glutenfreeworks.com
john.libonati@glutenfreeworks.com

Discussion | | Nadine Grzeskowiak | May 13, 2008

I have thought for a long time about this very question.  Who would suggest such a thing?  I would.  The main reason I would dare to make such a statement is because we have been so negligent in recognizing and treating people with celiac disease.  Not a day goes by that I don’t hear about or speak to someone directly who has suffered needlessly for years.  The other main point I want to make is that NONE of the currently available testing is 100%.  The blood tests and endoscopic biopsies are great tools if they are positive.  If they are negative, I have heard of too many people tell me ‘I don’t have celiac disease, my blood test/biopsy was negative’.  This is a major cause for concern to me.  Both of these tests do not confirm you don’t have, or will never develop celiac disease.  First, neither test is 100% reliable.  Second, both tests are simply a snapshot of right now.  I have also seen test results that are clearly positive for celiac disease, but read as negative by a medical provider that does not understand what the results mean.  The genetic testing is great and it is my first choice when testing people.  The test is a cheek swab, I get results in one week and it is covered by most insurances.  I utilize Kimball Genetics in Denver, Colorado,  www.kimballgenetics.com.  I have run into this scenerio in the past week: a 12 year old on a gluten free diet for several months, a remarkable recovery from many symptoms while on the gluten free diet, and yet, she tests negative for DQ2 and DQ8.  Is she at risk for celiac disease if she eats gluten?  Are there other genes that could be looked at?  I am gathering more data on this because nothing is black and white with gluten intolerance, there are many grey areas.  Other than, of course, the need to be on a strict gluten free diet for the rest of your life if you have celiac disease.  Not much grey there. 

So, this leads me back to the original question: everyone on a gluten free diet?  In my perfect world, the answer would be a resounding YES!  If people would simply try the gluten free diet for a month, most, if not all of those people will feel better.  It remains simply a diet change.  Change your diet and feel better, doesn’t that sound appealing.  To some yes, and to others, not really. Not without the proof that they need to change their long held diet and lifestyle habits.  It also sounds quite un-American to say ‘I can’t eat wheat, barley, rye and oats’, by extension, bread, pies, cakes, beer and pizza.  My most recent convert to a gluten free diet, said to me, “You know I don’t even miss the bread anymore, it doesn’t even appeal to me, I feel so much better on the gluten free food”.  This is a woman who has had symptoms for most of her 76 years and I had a hard time convincing her to try the gluten free diet for a month.  She is convinced now.  I can tell many stories with the same happy ending.  I can also tell you that most men have a harder time changing anything, let alone their diet, than women.  Trust me, I am a nurse and I have no reason to lie to you.  Try it.  Go gluten free for a month and contact me with your results.  GO!

Health Alert – Fatty Liver Disease and Celiac Disease

We have some very important information to share with you today.

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.

According to our new book, “Recognizing Celiac Disease”, 3.4% of people with non-alcoholic fatty liver disease have SILENT Celiac Disease. Most patients DO NOT have gastrointestinal symptoms.

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.

The good news is that studies showed liver enzymes normalize after 6 months on a gluten-free diet.

If you have patients or family members with non-alcoholic fatty liver (cirrhosis), who are not diagnosed with celiac disease, give them this information so they can get tested.

Related medical studies are referenced in “Recognizing Celiac Disease.” www.recognizingceliacdisease.com.

Celiac disease is a multi-system, hereditary, chronic, auto-immune disease estimated to affect 1% of the human population (3 million in the US) that is caused by the ingestion of wheat, barley, rye and oats. It is treated by removing these items from the diet. Signs, symptoms, associated disorders and complications can affect any part of the body and removal of the offending foods can result in complete recovery.  

Neurological Disorders, Gluten & Celiac Disease

The brain is a delicate organ, where billions of cells, electrical and chemical reactions have to interact correctly to function optimally.  When something unbalances brain chemistry, interrupts reactions or damages the cells, brain dysfunction results. Gluten does all these things – whether or not you have celiac disease.

Neurological disorders from gluten can arise in either, or both, of the following ways.  Gluten can penetrate the intestinal lining and enter the bloodstream, by its own mechanism, travel to the brain where it can damage or disrupt cells or cause inflammation.  This is the direct effect of gluten on the brain.  Gluten can also lead to malabsorption of nutrients in celiac disease.  In this case, the body does not absorb the nutrients it needs. Nutrients are chemicals. The brain, therefore, does not receive the chemicals it needs to function correctly and problems develop.

Nervous system disorders have been found in over 50% of newly diagnosed celiacs.  The list of nervous disorders is long: autism, gait ataxia, gluten ataxia, progressive myoclonic ataxia, chorea, tremors, brain atrophy, cerebral perfusion abnormalities, cortical calcifying angiomatosis (cerebral calcifications), dementia, headaches, epilepsy, chronic fatigue and chronic fatigue syndrome, migraines, multiple sclerosis, vasculitis of the central nervous system, chronic maladaptive anxiety, apathy, depression, inability to concentrate, insomnia, irritability, schizophrenia spectrum disorders, and peripheral neuropathy.  New disorders are being added as the link between

These nervous disorders can include either hard or soft disorders.

Examples of hard disorders would be epilepsy, ataxia (motor abnormalities), myoclonus, internuclear ophthalmoplegia, multifocal leukoencephlopathy, dementia and peripheral neuropathies.  Hard disorders, besides peripheral neuropathies, do not respond to gluten restriction – so identifying gluten sensitivity and/or celiac disease early is critical.

Soft disorders in celiac disease include a broad range of what are considered common neurological disorders.  Hypotonia (flaccid muscles in babies), developmental delay, learning disorders and ADHD, headaches and cerebellar ataxia are examples.  Importantly, there does not seem to be a difference in whether people with infantile-onset gastrointestinal symptoms, those with late onset symptoms or are asymptomatic (have no symptoms at all) develop soft disorders.

This means you may never experience a gastrointestinal symptom, yet still suffer from neurological disorder due to celiac disease.

Recovery from these neurological disorders usually depends on length of time gluten has been digested. The gluten-free diet can result in complete recovery, improvement or no recovery depending on the amount of damage incurred. This means the earlier gluten is removed from the diet, the greater the likelihood of successful recovery.

For these reasons, anyone with an unexplained neurological disorder that does or does not respond to traditional treatment should be screened for celiac disease and gluten sensitivity.

(This Health Alert was taken from information found in Issue #10 – “How Gluten Perturbs the Brain” of the Gluten Free Gazette.)

Celiac disease is a hereditary, auto-immune disorder estimated to affect 1% of the human population (3 million in the US). Less than 3 % are estimated to be medically diagnosed, but numbers are expected to rapidly increase as diagnosis improves. Celiac disease is caused by the ingestion of wheat, barley, rye and oats and treated by removing these items from the diet. Signs, symptoms, associated disorders and complications can affect any part of the body and removal of the offending foods can result in complete recovery.

Visit Glutenfreeworks.com for more information.

Yes, You Can Die From Celiac Disease

You can definitely die from celiac disease, in a variety of ways:

1. Dehydration – Extreme damage to the intestinal lining can lead to death through dehydration.  In this case, the lining that is supposed to hold water in your body no longer functions.  The gut actually pulls water from your body.

2. Malignancies – Malabsorption of nutrients or consistent damage to cellular structures leads to cancers: lymphoma, leukemia, intestinal, esophageal, etc.

3. Pregnancy complications – Nutrient deficiencies can lead to cardiomyopathy in the mother or birth defects in the fetus from folic acid deficiency, protein deficiency, etc.

4. Immunodeficiency – A weakened immune system can allow common illnesses to become deadly – the flu for example.  Other illnesses normally fought off, are not.

5. Autoimmune diseases – Celiac disease, if not diagnosed and treated early, causes the body to react to other things in the body.  As the body tries to unsuccessfully attack and remove gluten (because the person keeps eating it), the immune system stays on a heightened alert and starts attacking other things.

6. Malnutrition – Any health problem that comes from malnutrition of any one or more nutrient that can lead to death can be caused by celiac disease.

Here are just 6 examples of how celiac disease can kill you.  It is a deadly serious condition caused by eating what is essentially a poison to susceptible people – people with celiac disease.

The gluten-free diet is the elimination of gluten from the diet.  That is only the first step.  The next step is determining any health problems that have arisen and treating them.  The final step is ongoing identification of health problems that arise in the future to determine how to treat yourself.

-John Libonati

John Libonati is Vice President and co-Founder of Gluten Free Works, Inc. He can be reached at john.libonati@glutenfreeworks.com.

Scientists uncover further steps leading to celiac disease

Contact: Sally Webster
s.webster@qmul.ac.uk
44-207-882-5404
Queen Mary, University of London

Scientists who last year identified a new genetic risk factor for coeliac disease, have, following continued research, discovered an additional seven gene regions implicated in causing the condition. The team, lead by David van Heel, Professor of Gastrointestinal Genetics at Barts and The London School of Medicine and Dentistry, have further demonstrated that of the nine coeliac gene regions now know, four of these are also predisposing factors for type 1 diabetes. Their research sheds light not only on the nature of coeliac disease, but on the common origins of both diseases. It is published online today (2 March 2008) in Nature Genetics.

Professor van Heel and his team, including collaborators from Ireland, the Netherlands, and the Wellcome Trust Sanger Institute, first performed a genome wide association study in coeliac disease. Genetic markers across the genome were compared in coeliac disease subjects versus healthy controls. They then assessed around 1,000 of the strongest markers in a further ~ 5,000 samples. Their results identified seven new risk regions, six of which harbour important genes critical in the control of immune responses, highlighting their significance in the development of the disease.

Coeliac disease is common in the West, afflicting around 1 per cent of the population. It is an immune-mediated disease, triggered by intolerance to gluten (a protein found in wheat, barley and rye containing foods), that prevents normal digestion and absorption of nutrients. If undetected it can lead to a number of often severe problems among them anaemia, poor bone health, fatigue and weight loss. Currently only a restricted diet can diminish symptoms.

Professor van Heel said: “So far our findings explain nearly half of the heritability of coeliac disease – now studies with many more samples from individuals with coeliac disease are needed to identify the precise causal genetic variants from each region, and understand how these influence biological processes.”

###

The research was funded by Coeliac UK and The Wellcome Trust. Coeliac disease case studies are available for interview from Coeliac UK upon request.

The paper, ‘Newly identified genetic risk variant for celiac disease related to the immune response’ is published online, on 2 March 2008, in Nature Genetics.

For case studies contact:
Kate Newman
Press Office
Coeliac UK
Tel: 020 8399 7478
Mobile: 07952 071014

Notes to editors:

Barts and The London School of Medicine and Dentistry offers international levels of excellence in research and teaching while serving a population of unrivalled diversity amongst which cases of diabetes, hypertension, heart disease, TB, oral disease and cancers are prevalent, within east London and the wider Thames Gateway. Through partnership with our linked trusts, notably Barts and The London NHS Trust, and our associated University Hospital trusts – Homerton, Newham, Whipps Cross and Queen’s – the School’s research and teaching is informed by an exceptionally wide ranging and stimulating clinical environment.

At the heart of the School’s mission lies world class research, the result of a focused programme of recruitment of leading research groups from the UK and abroad and a £100 million investment in state-of-the-art facilities. Research is focused on translational research, cancer, cardiology, clinical pharmacology, inflammation, infectious diseases, stem cells, dermatology, gastroenterology, haematology, diabetes, neuroscience, surgery and dentistry.

The School is nationally and internationally recognised for research in these areas, reflected in the £40 million it attracts annually in research income. Its fundamental mission, with its partner NHS Trusts, and other partner organisations such as CRUK, is to ensure that that the best possible clinical service is underpinned by the very latest developments in scientific and clinical teaching, training and research.

Websites
www.coeliac.org.uk
www.coeliac.co.uk/about_us/press_office/writing_about_coeliac_disease/118.asp
http://www.wellcome.ac.uk
http://www.icms.qmul.ac.uk/
http://www.icms.qmul.ac.uk/Profiles/Gastro/van%20Heel%20David.htm
http://www.nature.com/ng/index.html

Problems with Acid Reducers and Acid Reflux Fixes that Work

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

>