{"id":764,"date":"2014-12-29T19:35:30","date_gmt":"2014-12-30T00:35:30","guid":{"rendered":"http:\/\/www.mynutriguide.com\/?p=764"},"modified":"2020-07-11T10:50:45","modified_gmt":"2020-07-11T14:50:45","slug":"xerophthalmia-2","status":"publish","type":"post","link":"https:\/\/glutenfreeworks.com\/health\/xerophthalmia-2\/","title":{"rendered":"Xerophthalmia"},"content":{"rendered":"<div id=\"attachment_7192\" style=\"width: 310px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/xerosis-xeophthalmia.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-7192\" class=\"size-medium wp-image-7192 \" style=\"margin-left: 5px;margin-right: 5px\" src=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/xerosis-xeophthalmia-300x194.jpg\" alt=\"Marked conjunctival and corneal xerosis. The entire bulbar conjunctiva is dry and thickened and almost skinlike. (Sommer A, Sugana T, Djunaedi E, Green R: Vitamin A-responsive panocular xerophthalmia in a healthy adult. Arch Ophthalmol 96:1630, 1978)\" width=\"300\" height=\"194\" srcset=\"https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/xerosis-xeophthalmia-300x194.jpg 300w, https:\/\/glutenfreeworks.com\/health\/wp-content\/uploads\/sites\/10\/xerosis-xeophthalmia.jpg 580w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><p id=\"caption-attachment-7192\" class=\"wp-caption-text\">Marked conjunctival and corneal xerosis. The entire bulbar conjunctiva is dry and thickened and almost skinlike. <em>(Sommer A, Sugana T, Djunaedi E, Green R: Vitamin A-responsive panocular xerophthalmia in a healthy adult. Arch Ophthalmol 96:1630, 1978)<\/em><\/p><\/div>\n<h2>What Is Xerophthalmia?<\/h2>\n<p style=\"text-align: justify\"><span class=\"dropcap\">X<\/span>erophthalmia is a serious condition of extreme drying and thickening of the conjunctiva following chronic inflammation and failure to make tears, characterized by hazy, dry cornea.<\/p>\n<p style=\"text-align: justify\">Vitamin A is obtained from the diet and is required in the cornea for maintaining epithelial (surface cell) health.<a href=\"#footnote_1_764\" id=\"identifier_1_764\" class=\"footnote-link footnote-identifier-link\" title=\"Alwitry A. Vitamin A deficiency in coeliac disease.&nbsp;Br J Ophthalmol.&nbsp;2000 September; 84(9): 1075.&nbsp;doi:&nbsp; 10.1136\/bjo.84.9.1075e\">1<\/a><\/p>\n<p style=\"text-align: justify\">Xerophthalmia\u00a0is most often associated with malnutrition involving chronic, severe vitamin A deficiency and may develop from chronic liver disease, intestinal disorders such as celiac disease,\u00a0pancreatitis, and extensive bowel surgery that cause malabsorption.<\/p>\n<p style=\"text-align: justify\">It may also develop in autoimmune diseases such as Sjogrens syndrome.<\/p>\n<p style=\"text-align: justify\"><strong>Q<\/strong>: What is the prognosis for xerophthalmia?<\/p>\n<p style=\"text-align: justify\"><strong>A<\/strong>: Xerophthalmia has\u00a0the potential to rapidly advance to corneal necrosis (keratomalacia) and blindness.<\/p>\n<h2>What Is Xerophthalmia In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<p><!--more--><\/p>\n<ul class=\"cp_check red\">\n<li style=\"text-align: justify\"><strong>Relationship between xerophthalmia and celiac disease.<\/strong> Xerophthalmia is an alarming manifestation of severe vitamin A deficiency due to malabsorption<a href=\"#footnote_2_764\" id=\"identifier_2_764\" class=\"footnote-link footnote-identifier-link\" title=\"Sommer A. Xerophthalmia and vitamin A status. Prog Retin Eye Res. 1998 Jan;17(1):9-31.\">2<\/a> and a complication in celiac disease that can be a presenting feature of celiac disease.<\/li>\n<li style=\"text-align: justify\"><strong>Relationship between xerophthalmia and nightblindness.\u00a0<\/strong>A\u00a0history of nightblindness can be a specific and sensitive index of vitamin A deficiency and early xerophthalmia.<a href=\"#footnote_3_764\" id=\"identifier_3_764\" class=\"footnote-link footnote-identifier-link\" title=\"Sommer A, Hussaini G, Muhilal, Tarwotjo I, Susanto D, Saroso JS. History of nightblindness: a simple tool for xerophthalmia screening.&nbsp;Am J Clin Nutr. 1980 Apr;33(4):887-91.\">3<\/a><\/li>\n<\/ul>\n<h2>How Prevalent Is Xerophthalmia In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<ul class=\"cp_bullet black\">\n<li style=\"text-align: justify\">Xerophthalmia has increased frequency in untreated celiac disease.<\/li>\n<li style=\"text-align: justify\">A Dutch study investigating prevalence of deficiencies in 80 newly diagnosed patients found that 7.5% of patients showed deficient levels\u00a0vitamin A.<a href=\"#footnote_4_764\" id=\"identifier_4_764\" class=\"footnote-link footnote-identifier-link\" title=\"Wierdsma NJ, van Bokhorst-de van der Schueren MA, Berkenpas M, Mulder CJ, van Bodegraven AA. Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients. Nutrients. 2013 Sep 30;5(10):3975-92. doi: 10.3390\/nu5103975.\">4<\/a><\/li>\n<\/ul>\n<h2>What Are The Symptoms Of Xerophthalmia?<\/h2>\n<ul class=\"cp_bullet red\">\n<li style=\"text-align: justify\">Early xerophthalmia is marked by dry, sandy eyes, lack of tearing, loss of visual acuity (ability to see clearly, blurred vision) and nightblindness.<\/li>\n<li style=\"text-align: justify\">Untreated, later xerophthalmia is marked by\u00a0keratinization (cell thickening) seen as\u00a0thick, white mucosa, possibly with Bitot&#8217;s spots (foamy patches), that leads to\u00a0ulceration of the cornea.<\/li>\n<li style=\"text-align: justify\">It must be noted that a benign intracranial hypertension (increased blood pressure), called\u00a0pseudotumor cerebri, in children can be associated with vitamin A deficiency\u00a0even when other\u00a0manifestations\u00a0of xerophthalmia do not exist. Symptoms of pseudotumor cerebri include moderately severe headaches associated with optic nerve swelling (papilledema) seen on eye examination by the opthalmologist. Early recognition of this condition and appropriate therapy can prevent the progression from blurring of vision to blindness.<a href=\"#footnote_5_764\" id=\"identifier_5_764\" class=\"footnote-link footnote-identifier-link\" title=\"Dotan G, Goldstein M, Stolovitch C, Kesler A. Pediatric Pseudotumor Cerebri Associated With Low Serum Levels of Vitamin A.&nbsp;J Child Neurol. 2013 Nov;28(11):1370-1377. Epub 2013 Jan 29.\">5<\/a><\/li>\n<\/ul>\n<h2>How Does Xerophthalmia Develop In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<ul class=\"cp_check red\">\n<li style=\"text-align: justify\">Xerophthalmia results mainly from vitamin A deficiency and protein malnutrition due to malabsorption in celiac disease.<\/li>\n<li style=\"text-align: justify\">EPA (omega-3 fatty acid) deficiency contributes to its development and progression.<\/li>\n<\/ul>\n<h2>Does Xerophthalmia Respond To Gluten-Free Diet?<\/h2>\n<p>Yes. Xerophthalmia can resolve on gluten free diet containing adequate vitamin A, EPA (omega-3 fatty acid), and protein. Initial oral supplementation is required to prevent further damage and quickly reverse the course.<\/p>\n<h2 style=\"text-align: justify\">6 Steps To Improve Xerophthalmia In Celiac Disease and\/or Gluten Sensitivity:<\/h2>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>1<\/strong><\/span><\/span><strong><span style=\"color: #800000\">Remove the Trigger. Maintain a Strict, Nutritious Gluten Free Diet:<\/span><\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<b>Treatment<\/b>. This condition responds to the complete elimination of gluten, which is the required treatment that improves both eye and gut health.<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Gut health is the foundation to restore ALL health. Restored health will enable you to maintain a strict gluten free diet, just as other life tasks will be easier.<\/li>\n<li>A strict gluten free diet means removing 100% of wheat, barley, rye and oats from the diet.<\/li>\n<li>Cutting out bread and other obvious sources of gluten is not good enough for recovery. Even 1\/8th teaspoon of flour or bread crumb is enough to sustain the inflammation that is damaging your small intestine, causing increased permeability (leaky gut) and allowing undigested gluten to enter your body where it can damage structures and function, and instigate immune inflammatory responses.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Correct Your Individual Nutritional Needs.<\/strong><\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Eat foods that can replenish missing nutrients. Find them under\u00a0NUTRIENT DEFICIENCIES.<\/li>\n<li>Take nutritional supplements as needed.\u00a0Find them under\u00a0NUTRIENT DEFICIENCIES.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Recovery<\/strong>. You should begin to feel better within a week and notice more energy as inflammation subsides and the \u00a0absorbing cells that make up the surface lining of your small intestine are better able to function.<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Intestinal lining cells are replaced every 5 days. The healing process is like sunburn where the damaged surface layer of skin sloughs off and is replaced with new normal cells.<\/li>\n<li>Leaky gut normally resolves in two month after starting a gluten free diet and brings about a big improvement in health. Improvement in intestinal permeability precedes morphometric recovery (cell appearance and structure) of the small intestine in celiac disease.<a href=\"#footnote_6_764\" id=\"identifier_6_764\" class=\"footnote-link footnote-identifier-link\" title=\"Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease.&nbsp;Clinical Science. Apr 2001;100(4):379-86.\">6<\/a><\/li>\n<li>The intestinal lining may take up to a year to heal.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><em><span style=\"color: #800000\"><span class=\"dropcap\"><strong>2<\/strong><\/span><\/span><strong><span style=\"color: #800000\">\u00a0Reduce Inflammation. Foods to Eat and Foods Not to Eat:<\/span><\/strong><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\">Because gluten is inflammatory, eliminate OTHER inflammatory foods from your diet to reduce an additive effect to gluten. At the same time, try to eat foods that reduce inflammation (anti-inflammatory).<\/p>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Here Are Major Inflammatory Food Types That Reduce Healing<\/strong>:<\/p>\n<ul class=\"cp_bullet red\" style=\"text-align: justify\">\n<li><strong>Damaging Foods<\/strong>. In susceptible persons, includes corn, dairy (cow), and soy. Lactose, the sugar in any animal milk disrupts intestinal permeability causing leaky gut.<a href=\"#footnote_7_764\" id=\"identifier_7_764\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">7<\/a><\/li>\n<li><strong>Allergenic Foods<\/strong>. Includes foods that trigger the immune sytem to produce IgE antibodies. Allergy testing is the usual way to discover these offending foods.<\/li>\n<li><strong>Shelf Stable Processed Foods.\u00a0<\/strong>Includes any that contain additives and preservatives. Look for them on the nutrition label of the box or package. Additives and preservatives also disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_7_764\" id=\"identifier_8_764\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">7<\/a><\/li>\n<li><strong>Fats.<\/strong>\u00a0Limit deep fried foods, trans-fats, saturated fats (animal fat\/butter), and EXCESSIVE omega-6 fatty acid oils like corn oil. Rancid fats, sodium caprate (a medium chain fat), and sucrose monester fatty acid (a food grade surfactant) induce significant disruption of the intestinal barrier that causes leaky gut.<a href=\"#footnote_7_764\" id=\"identifier_9_764\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">7<\/a>.<\/li>\n<li><strong>Excessive Refined White Flours\u00a0<\/strong>(bran layer removed)<strong>.\u00a0<\/strong>Includes\u00a0products made from them such as cookies, bread, cakes, pies.\u00a0Bran contains the vitamins and minerals that metabolize grains and slows the otherwise rapid entry of sugar from their digestion into the bloodstream.\u00a0Also disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_7_764\" id=\"identifier_10_764\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">7<\/a><\/li>\n<li><strong>Refined Sugars.\u00a0<\/strong>\u00a0Includes white sugar, corn fructose and high fructose corn syrup.<\/li>\n<li><strong>Certain Spices<\/strong>. Includes paprika and cayenne pepper which disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_7_764\" id=\"identifier_11_764\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">7<\/a><\/li>\n<li><strong>Alcohol and Caffeine<\/strong>. Disrupt intestinal permeability causing leaky gut.<a href=\"#footnote_7_764\" id=\"identifier_12_764\" class=\"footnote-link footnote-identifier-link\" title=\"Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.&nbsp;Journal of Gastroenterology and Hepatology. 2003;18:479-91.\">7<\/a>\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Here Are Important Anti-Inflammatory Food Types to Promote Health<\/strong>:<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li><strong>Fruits<\/strong>.\u00a0Contain ample amounts of vitamins, minerals and phytochemicals which are\u00a0naturally occuring components in plants that detoxify toxins, carcinogens (reducing the risk by 50%) and mutagens.<\/li>\n<li><strong>Non-Starchy Vegetables.<\/strong>\u00a0Support intestinal integrity and provide ample amounts of vitamins, minerals and phytochemicals. Includes lettuce, kale, onion, broccoli, garlic, and others.<\/li>\n<li><strong>High Quality Complex Carbohydrates<\/strong>. Provide vitamins, minerals, and fiber while boosting serotonin levels to help you relax and feel calm. Includes whole grains, legumes, and root vegetables such as carrots, parsnips, sweet potatoes, turnips, red beets, and others.<\/li>\n<li><strong>Antioxidants<\/strong>. Protect the body from inflammatory oxidant molecules that continually occur and\u00a0help us handle stress and reduce irritability. Includes vitamin C-containing foods such as lemon, grapefruit, apricot, Brussels sprouts and strawberries, and others. Also, includes vitamin E-containing foods such as\u00a0nuts, seeds, avocado, olive oil, and others. Cocoa is good, too.<\/li>\n<li><strong>Omega-3 Fatty Acids<\/strong>. Balance opposing omega-6 fatty acids and bad fats. Fish sources includes tuna, salmon, cod, and others. Plants sources include flax, chia seeds, canola oil, and others.<\/li>\n<li><strong>Probiotics.\u00a0<\/strong>Supply normal microbes needed for colon health and health of the body such as these fermented foods: yogurt, kefir, and unpasteurized apple cider vinegar.<\/li>\n<li><strong>Prebiotics\/ High Fiber Foods<\/strong>. \u00a0Food with fiber keeps our population of colonic microbes healthy.<\/li>\n<li><strong>Protective Herbs and Spices<\/strong>. \u00a0See below #6 below for examples.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><em><span style=\"color: #800000\"><strong><span class=\"dropcap\">3<\/span>\u00a0Information Sheet You Can Take to Your Doctor or Other Health Professional:<\/strong><\/span><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\">Click here.<\/p>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><span style=\"color: #800000\"><strong><em><span class=\"dropcap\">4<\/span>\u00a0Manage Your Medications\u00a0Safely<\/em>:<\/strong><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<p style=\"text-align: justify\">Certain medications deplete vitamin A that promotes xerophthalmia in malnutrition. Ask your doctor or pharmacist about this possible adverse effect if you are taking any of the drugs listed below.\u00a0<strong>Do not stop prescribed medications without supervision.<\/strong><\/p>\n<p>\u00a0This is not a complete listing.<\/p>\n<p style=\"text-align: justify\"><strong>CHOLESTEROL DRUGS<\/strong><\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Colestid\u00ae and Questran\u00ae deplete\u00a0Vitamin A.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>ANTACIDS \/ ULCER MEDICATIONS<\/strong><\/p>\n<ul class=\"cp_bullet blue\" style=\"text-align: justify\">\n<li>Pepcid\u00ae, Tagamet\u00ae, Zantac\u00ae deplete Vitamin A.<\/li>\n<li>Magnesium and Aluminum Antacid preparations (Gaviscon\u00ae, Maalox\u00ae, Mylanta\u00ae) deplete Vitamin A.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><em><span style=\"color: #800000\"><strong><span class=\"dropcap\">5<\/span>Nutritional Supplements To Help Correct Deficiencies:<\/strong><\/span><\/em><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t\n<p style=\"text-align: justify\">The type and quantity of nutritional supplements that may be needed depend on which nutrients are deficient.<\/p>\n<ul class=\"cp_bullet orange\" style=\"text-align: justify\">\n<li>Multivitamin\/mineral combination once a day is useful to improve overall nutrient levels. This is a safe dose, but always check with your doctor to avoid interactions with medications.<\/li>\n<li>Vitamin A as prescribed following a blood test for vitamin A status.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Storage Note<\/strong>:\u00a0<em>Store container tightly sealed, away from heat, moisture and direct light to avoid loss of potency. That is, in a safe kitchen cabinet &#8211; not in the bathroom or on the kitchen table<\/em>.\n\t\t\t<\/div><\/div>\n<ul class=\"cp_check green\" style=\"text-align: justify\">\n<li><span style=\"color: #800000\"><em><strong><span class=\"dropcap\">6<\/span>Manage Natural Remedies:\u00a0<\/strong><\/em><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Hydration<\/strong>:<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Eight glasses of water are recommended per day unless there is a contraindication such as kidney or heart disease. The Institute of Medicine recommends approximately 2.7 liters (91 ounces) of total water, from all beverages and foods, each day for women and 3.7 liters (125 ounces) daily of total water for men.<\/li>\n<li>If you are thirsty, drink water. Add fresh, squeezed lemon to water. Lemon is anti-inflammatory, alkalizing and provides vitamin C.<\/li>\n<li>Hydration Test: Urine should be pale yellow. Fingertips should be plump, without pruning but this may not be reliable when fingers are swollen with edema. Lips should be plump, without puckering. The feeling of thirst can be unreliable.<\/li>\n<li>What is wrong with soda, coffee, tea, and alcohol? These drinks are dehydrating, increase acid, and deplete nutrients.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<p style=\"text-align: justify\"><div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Carminatives.\u00a0<\/strong>The following \u00a0anti-inflammatory\u00a0plant sources called carminitives help heal the digestive tract. They also tone the digestive muscles which improves peristalsis, thus aiding in the expulsion of gas from the stomach and intestine to relieve digestive colic and gastric discomfort.<\/p>\n<p style=\"text-align: justify\"><strong>Carminative Food Remedies<\/strong>:<\/p>\n<ul class=\"cp_bullet green\" style=\"text-align: justify\">\n<li>Raspberry.<\/li>\n<li>Carrot is also a cleansing digestive tonic.<\/li>\n<li>Grape is also bile stimulating and a cleansing remedy for sluggish digestion and laxative.<\/li>\n<li>Redbeets also stimulate and improve digestion and are easily digested.<\/li>\n<li>Cabbage also stimulates and improves digestion and is also a liver decongestant.<\/li>\n<li>Lettuce also stimulates and improves digestion and is also an alterative, meaning it improves the function of organs involved with the digestion and excretion of waste products to bring about a gradual change.<\/li>\n<li>Potatoes are antispasmodic (due to atropine like properties) and a liver remedy.<\/li>\n<\/ul>\n<p style=\"text-align: justify\"><strong>Carminative Herb Remedies:<\/strong><\/p>\n<ul class=\"cp_bullet green\">\n<li style=\"text-align: justify\">Sage is also a digestive, astringent, bile stimulant and energy tonic that heals the mucosa. \u00a0Drink as tea or use in cooking.<\/li>\n<li style=\"text-align: justify\">Chamomile, lemon balm, and fennel, (as a tea) also help relieve nervous tension.<\/li>\n<li style=\"text-align: justify\">Parsley also relieves indigestion.<\/li>\n<li style=\"text-align: justify\">Rosemary as a tea and in cooking also is a nervous system tonic for stress and fatigue, bile stimulant, and can relieve headaches and indigestion.<\/li>\n<li style=\"text-align: justify\">Thyme is also soothing remedy useful for stimulating digestion of rich, fatty foods.<\/li>\n<\/ul>\n<p><strong>Carminative Spice Remedies:<\/strong><\/p>\n<ul class=\"cp_bullet green\">\n<li>Cloves are also antispasmodic.<\/li>\n<li>Nutmeg is also useful for indigestion.<\/li>\n<li>Ginger.\n\t\t\t<\/div><\/div><\/li>\n<\/ul>\n<div class=\"box shadow\"><div class=\"box-inner-block\"><i class=\"tieicon-boxicon\"><\/i>\n\t\t\t<strong>Exercise Helps<\/strong>:<\/p>\n<p>Exercise improves circulation and rids the body of toxins.<\/p>\n<ul class=\"cp_bullet green\">\n<li>Walking is aerobic exercise that reconditions the whole body to improve stamina.\u00a0Read more about<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">\u00a0Exercise and Fitness<\/a>.<\/li>\n<li>Weight training builds muscle.\u00a0Read more about\u00a0<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">Exercise and Fitness<\/a>.<\/li>\n<li>Stretching improves flexibilty.\u00a0Read more about\u00a0<a href=\"https:\/\/glutenfreeworks.com\/health\/2014\/07\/08\/fitness-guide\/\">Exercise and Fitness<\/a>.<\/li>\n<\/ul>\n<p><strong>Note<\/strong>: Exercise is important, but the amount and type of exercise undertaken depends on your health. Your first priority is to heal. \n\t\t\t<\/div><\/div>\n<h2>What Do Medical Research Studies Tell About Xerophthalmia In Celiac Disease and\/or Gluten Sensitivity?<\/h2>\n<h4><strong>RESEARCH STUDY SUMMARIES<\/strong><\/h4>\n<p style=\"text-align: justify\"><strong>&#8220;Pediatric Pseudotumor Cerebri Associated With Low Serum Levels of Vitamin A.&#8221;<\/strong>\u00a0The aim of this study was to describe the association between pediatric pseudotumor cerebri and low serum vitamin A levels. We retrospectively reviewed the charts of 6 children (5 boys, 1 girl; mean age 8 years) with increased intracranial pressure and low serum vitamin A levels (mean 16.0 \u00b1 8.8 \u00b5g\/dL). The etiology of the\u00a0vitamin A deficiency\u00a0was a restricted diet (2 children), intestinal malabsorption caused by celiac disease (2 children), and undetermined cause (2 children). Only 1 child had\u00a0ocular\u00a0signs of xerosis.<\/p>\n<p style=\"text-align: justify\">Poor visual acuity at presentation and lower serum vitamin A levels were associated with a poor visual outcome and development of optic nerve atrophy. In conclusion, pseudotumor cerebri in children can be associated with vitamin A deficiency\u00a0even when other\u00a0manifestations\u00a0of xerophthalmia do not exist. Early recognition of this condition and appropriate therapy can prevent blindness.<a href=\"#footnote_8_764\" id=\"identifier_13_764\" class=\"footnote-link footnote-identifier-link\" title=\"Dotan G, Goldstein M, Stolovitch C, Kesler A. Pediatric Pseudotumor Cerebri Associated With Low Serum Levels of Vitamin A. J Child Neurol. 2013 Nov;28(11):1370-1377.\">8<\/a><\/p>\n<p style=\"text-align: justify\"><b>\u201cVitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients.\u201d<\/b>\u00a0This study aiming to assess the nutritional and vitamin\/mineral status of current &#8220;early diagnosed&#8221; untreated adult celiac disease (CD)-patients in the Netherlands found that vitamin\/mineral deficiencies are still common in newly &#8220;early diagnosed&#8221; CD-patients, even though the prevalence of obesity at initial diagnosis is rising. Eighty newly diagnosed adult CD-patients were included and a comparable sample of 24 healthy Dutch subjects was added to compare vitamin concentrations.<\/p>\n<p style=\"text-align: justify\">Nutritional status and serum concentrations of \u00a0various nutrients including vitamin A were assessed before prescribing gluten free diet. Almost all CD-patients (87%) had at least one value below the lower limit of reference. Specifically, for\u00a0vitamin A, 7.5% of patients showed deficient levels. Overall, 17% were malnourished (&gt;10% undesired weight loss), 22% of the women were underweight (Body Mass Index (BMI) &lt; 18.5), and 29% of the patients were overweight (BMI &gt; 25). Vitamin deficiencies were barely seen in healthy controls, with the exception of vitamin B\u2081\u2082. Vitamin\/mineral deficiencies were counter-intuitively not associated with a (higher) grade of histological intestinal damage or (impaired) nutritional status. Extensive nutritional assessments seem warranted to guide nutritional advices and follow-up in CD treatment.<a href=\"#footnote_9_764\" id=\"identifier_14_764\" class=\"footnote-link footnote-identifier-link\" title=\"Wierdsma NJ, van Bokhorst-de van der Schueren MA, Berkenpas M, Mulder CJ, van Bodegraven AA. Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients. Nutrients. 2013 Sep 30;5(10):3975-92. doi: 10.3390\/nu5103975.\">9<\/a><\/p>\n<p style=\"text-align: justify\"><strong>\u201cCorneal manifestations in Vitamin A deficiency.\u201d<\/strong>\u00a0This study investigating alterations in the anterior segmant of the eye demonstrated vitamin A deficiency can be the reason for bilateral conjunctiva manifestations.<a href=\"#footnote_10_764\" id=\"identifier_15_764\" class=\"footnote-link footnote-identifier-link\" title=\"Sadowski B, Rohrback JM, Steuhl KP, Weidle EG, Castrillon-Obendorfer WL. Corneal manifestations in Vitamin A deficiency.&nbsp;Klinische Monatsblatter fur Augenheilkunde. Aug 1994;205(2)76-85.\">10<\/a><\/p>\n<p style=\"text-align: justify\"><strong>\u201cHistory of nightblindness: a simple tool for xerophthalmia screening.&#8221;<\/strong> Among 5925 preschool-age children examined in a house to house rural field study, X1B (Bitot&#8217;s spot with xerosis) and\/or an history of nightblindness (XN) was presented in 325. Mean serum vitamin A levels among those with isolated XN (13.9 microgram\/dl), isolated X1B (13.4 micrograms\/dl), and coexistent XN\/X1B (12.1 microgram\/dl) were similar, and significantly below that of normal age\/sex\/neighborhood matched controls (17.6, 17.1, and 18.3 microgram\/dl, respectively). The mean serum vitamin A level of the matched controls was significantly below that of normal, randomly sampled children from the study population as a whole (20.6 microgarm\/dl).<\/p>\n<p style=\"text-align: justify\">As independent screening criteria, disregarding the presence of absence of other signs, twice as many children had a history of XN as had X1B (84 and 41% of all clinically abnormal children, respectively). Of randomly sampled children 55% but only 15% of cases of XN had serum vitamin A levels above 20 microgram\/dl. Of children with a history of nightblindness 97% had impaired scotopic vision on objective testing, but the mean serum vitamin A levels among test positives and negatives were identical.<\/p>\n<p style=\"text-align: justify\">These results suggest a properly elicited history of nightblindness can be almost as specific and far more sensitive an index of vitamin A deficiency and early xerophthalmia\u00a0than the prescence of Bitot&#8217;s spots.<a href=\"#footnote_11_764\" id=\"identifier_16_764\" class=\"footnote-link footnote-identifier-link\" title=\"Sommer A, Hussaini G, Muhilal, Tarwotjo I, Susanto D, Saroso JS. History of nightblindness: a simple tool for xerophthalmia screening. Am J Clin Nutr. 1980 Apr;33(4):887-91.\">11<\/a><\/p>\n<ol class=\"footnotes\"><li id=\"footnote_1_764\" class=\"footnote\">Alwitry A. Vitamin A deficiency in coeliac disease.\u00a0<em>Br J Ophthalmol.<\/em>\u00a02000 September; 84(9): 1075.\u00a0doi:\u00a0 10.1136\/bjo.84.9.1075e<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_1_764\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_2_764\" class=\"footnote\">Sommer A. Xerophthalmia and vitamin A status. <em>Prog Retin Eye Res<\/em>. 1998 Jan;17(1):9-31.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_2_764\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_3_764\" class=\"footnote\">Sommer A, Hussaini G, Muhilal, Tarwotjo I, Susanto D, Saroso JS. History of nightblindness: a simple tool for xerophthalmia screening.\u00a0<em>Am J Clin Nutr<\/em>. 1980 Apr;33(4):887-91.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_3_764\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_4_764\" class=\"footnote\">Wierdsma NJ, van Bokhorst-de van der Schueren MA, Berkenpas M, Mulder CJ, van Bodegraven AA. Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients. <em>Nutrient<\/em>s. 2013 Sep 30;5(10):3975-92. doi: 10.3390\/nu5103975.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_4_764\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_5_764\" class=\"footnote\">Dotan G, Goldstein M, Stolovitch C, Kesler A. Pediatric Pseudotumor Cerebri Associated With Low Serum Levels of Vitamin A.\u00a0<em>J Child Neurol<\/em>. 2013 Nov;28(11):1370-1377. Epub 2013 Jan 29.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_5_764\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_6_764\" class=\"footnote\">Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease.\u00a0<em>Clinical Science<\/em>. Apr 2001;100(4):379-86.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_6_764\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_7_764\" class=\"footnote\">Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease.\u00a0<em>Journal of Gastroenterology and Hepatology<\/em>. 2003;18:479-91.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_7_764\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_8_764\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_9_764\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_10_764\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_11_764\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_12_764\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_8_764\" class=\"footnote\">Dotan G, Goldstein M, Stolovitch C, Kesler A. Pediatric Pseudotumor Cerebri Associated With Low Serum Levels of Vitamin A. <em>J Child Neurol<\/em>. 2013 Nov;28(11):1370-1377.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_13_764\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_9_764\" class=\"footnote\">Wierdsma NJ, van Bokhorst-de van der Schueren MA, Berkenpas M, Mulder CJ, van Bodegraven AA. Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients. <em>Nutrients.<\/em> 2013 Sep 30;5(10):3975-92. doi: 10.3390\/nu5103975.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_14_764\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_10_764\" class=\"footnote\">Sadowski B, Rohrback JM, Steuhl KP, Weidle EG, Castrillon-Obendorfer WL. Corneal manifestations in Vitamin A deficiency.\u00a0<em>Klinische Monatsblatter fur Augenheilkunde<\/em>. Aug 1994;205(2)76-85.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_15_764\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><li id=\"footnote_11_764\" class=\"footnote\">Sommer A, Hussaini G, Muhilal, Tarwotjo I, Susanto D, Saroso JS. History of nightblindness: a simple tool for xerophthalmia screening. <em>Am J Clin Nutr<\/em>. 1980 Apr;33(4):887-91.<span class=\"footnote-back-link-wrapper\"> [<a href=\"#identifier_16_764\" class=\"footnote-link footnote-back-link\">&#8617;<\/a>]<\/span><\/li><\/ol>","protected":false},"excerpt":{"rendered":"<p>What Is Xerophthalmia? Xerophthalmia is a serious condition of extreme drying and thickening of the conjunctiva following chronic inflammation and failure to make tears, characterized by hazy, dry cornea. Vitamin A is obtained from the diet and is required in the cornea for maintaining epithelial (surface cell) health.1 Xerophthalmia\u00a0is most often associated with malnutrition involving &#8230;<\/p>\n","protected":false},"author":29,"featured_media":7192,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[4,783,210,1682,50,151],"tags":[896,1069,116,286,1965,452,776,1068,1512,1067,1359,1888,1930,901],"class_list":["post-764","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-conditions-2","category-complications-health-conditions-2","category-eyes","category-malabsorption-disorders","category-sensory-2","category-vitamin-a","tag-bitots-spots","tag-blurred-vision","tag-complications","tag-epa","tag-eyes","tag-headache","tag-health-conditions","tag-intracranial-hypetension","tag-nightblindness","tag-pseudotumor-cerebri","tag-sandy-dry-eyes","tag-sensory-2","tag-vitamin-a","tag-xerophthalmia"],"_links":{"self":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/764","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/users\/29"}],"replies":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/comments?post=764"}],"version-history":[{"count":17,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/764\/revisions"}],"predecessor-version":[{"id":15391,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/posts\/764\/revisions\/15391"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media\/7192"}],"wp:attachment":[{"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/media?parent=764"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/categories?post=764"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/glutenfreeworks.com\/health\/wp-json\/wp\/v2\/tags?post=764"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}