Gluten Free and Not Well
The following books, articles and websites can help give you an idea of what might be wrong if you are not doing well even though you are following the gluten-free diet
A book, Real Life with Celiac Disease, does a very good job of explaining additional problems that may be experienced by those with Celiac Disease. Highly Recommended.
Beth Israel Celiac Center has a very good section on their CeliacNow website: The Medical Management of Celiac Disease
Article: Additional recommendations to help you
make a full recovery from Celiac Disease
"Why Symptoms Persist - I'm on the diet and not getting better" is Chapter 16 of
Celiac Disease: A Hidden Epidemic (Revised and Updated Edition)
Effect of a Gluten-Free Diet on Gastrointestinal
Symptoms in Celiac Disease
Etiology of nonresponsive Celiac Disease:
Results of a systematic approach
Histologic Follow-up of People with Celiac Disease
on the Gluten-Free Diet: slow and incomplete recovery
List of autoimmune diseases associated with Celiac Disease
Small intestinal release mesalamine for the treatment of refractory celiac disease type I.
Prevalence of small intestine bacterial overgrowth diagnosed by
quantitative culture of intestinal aspirate in Celiac Disease
Small Intestinal Bacterial Overgrowth
from MedicineNet.com
Uninvited Guests: The Impact of Small Intestinal
Bacterial Overgrowth on Nutritional Status
Rifaxamin Therapy for Patients with Irritable Bowel Syndrome without Constipation
Rifaximin treats Irritable Bowel Syndrome
Articles about Xifaxan (rifaximin): 1, 2
This is an antibiotic used for irritable bowel syndrome and small intestinal bacterial overgrowth
Articles about Probiotics (see charts): Wall Street Journal, Wikipedia
Fermented Foods as a source of probiotics
Effect of Elemental Diet on ... type 1 refractory Celiac Disease
Update on the Management of Refractory Coeliac Disease (March 2007)
Differential Diagnosis of Persisting Villous Atrophy
Protein Intolerance
From this article: dairy, soy and egg protein are the most common problems.
"The simplest type of elimination diet is elimination of suspected food antigens from the diet for 2-4 weeks or longer."
Mucosal Reactivity to Cow's Milk Protein in Coeliac Disease
AGA Technical Review on the Evaluation of Food Allergy in Gastrointestinal Disorders
See page 9 of the pdf for a discussion of elimination diets
Guidelines for the Diagnosis and Management of Food Allergy in the United States
Risk Assessment of Trace and Undeclared Allergens in Processed Foods
A good description of elimination diets
Evaluation of the patient with suspected eosinophilic gastrointestinal disease (other than eosinophilic esophagitis)
This article is available for purchase online and is also at Ruth Lilly Medical Library
AGA Medical Position Statement: Guidelines for the Evaluation of Food Allergies
Clinical Aspects of Gastrointestinal Food Allergy in Childhood
Effect of six-food elimination diet on clinical and histological outcomes in eosinophilic esophagitis
Cincinnati Center for Eosinophilic Disorders at Cincinnati Children's Hospital
Quote from Textbook of Gastroenterology (2003, emphasis mine):
"Small amounts of antigenic macromolecules normally penetrate the gastrointestinal mucosal barrier and reach the systemic circulation, occurring more in early life and in conditions causing disruption of the mucosal defenses".
Note: Exposure to gluten increases intestinal permeability in everyone, although there tends to be a greater increase in people with CD (References 1 2). Increased intestinal permeabilitly may make people with CD more likely to have developed other food intolerances and allergies
Role of the Intestinal Barrier in Inflammatory Bowel Disease
includes a discussion of probiotics
Probiotic VSL#3 protects the epithelial barrier...in a murine model
Vitamin D has been demonstrated to play an important role in
intestinal mucosal barrier maintenance:
Novel role of the Vitamin D receptor in maintaining the integrity of the intestinal mucosal barrier
Protective Effect of 1,25-Dihydroxy Vitamin D3 on Pepsin-Trypsin-Resistant Gliadin-Induced TightJunction Injuries.
Celiac Disease and Recurrent Pancreatitis
This article shows the connection between Celiac Disease,
Sphincter of Oddi Dysfunction (aka papillary stenosis) and pancreatitis
Risk of Pancreatitis in 14,000 Individuals with Celiac Disease
Sphincter of Oddi Dysfunction: Diagnosis and Treatment
Treatment of Sphincter of Oddi Dysfunction by ERCP with manometry/sphincterotomy
is best done at a specialist such as Stuart Sherman at Indiana University
A book, Real Life with Celiac Disease, does a very good job of explaining additional problems that may be experienced by those with Celiac Disease. Highly Recommended.
Beth Israel Celiac Center has a very good section on their CeliacNow website: The Medical Management of Celiac Disease
Article: Additional recommendations to help you
make a full recovery from Celiac Disease
"Why Symptoms Persist - I'm on the diet and not getting better" is Chapter 16 of
Celiac Disease: A Hidden Epidemic (Revised and Updated Edition)
Effect of a Gluten-Free Diet on Gastrointestinal
Symptoms in Celiac Disease
Etiology of nonresponsive Celiac Disease:
Results of a systematic approach
Histologic Follow-up of People with Celiac Disease
on the Gluten-Free Diet: slow and incomplete recovery
List of autoimmune diseases associated with Celiac Disease
Small intestinal release mesalamine for the treatment of refractory celiac disease type I.
Prevalence of small intestine bacterial overgrowth diagnosed by
quantitative culture of intestinal aspirate in Celiac Disease
Small Intestinal Bacterial Overgrowth
from MedicineNet.com
Uninvited Guests: The Impact of Small Intestinal
Bacterial Overgrowth on Nutritional Status
Rifaxamin Therapy for Patients with Irritable Bowel Syndrome without Constipation
Rifaximin treats Irritable Bowel Syndrome
Articles about Xifaxan (rifaximin): 1, 2
This is an antibiotic used for irritable bowel syndrome and small intestinal bacterial overgrowth
Articles about Probiotics (see charts): Wall Street Journal, Wikipedia
Fermented Foods as a source of probiotics
Effect of Elemental Diet on ... type 1 refractory Celiac Disease
Update on the Management of Refractory Coeliac Disease (March 2007)
Differential Diagnosis of Persisting Villous Atrophy
Protein Intolerance
From this article: dairy, soy and egg protein are the most common problems.
"The simplest type of elimination diet is elimination of suspected food antigens from the diet for 2-4 weeks or longer."
Mucosal Reactivity to Cow's Milk Protein in Coeliac Disease
AGA Technical Review on the Evaluation of Food Allergy in Gastrointestinal Disorders
See page 9 of the pdf for a discussion of elimination diets
Guidelines for the Diagnosis and Management of Food Allergy in the United States
Risk Assessment of Trace and Undeclared Allergens in Processed Foods
A good description of elimination diets
Evaluation of the patient with suspected eosinophilic gastrointestinal disease (other than eosinophilic esophagitis)
This article is available for purchase online and is also at Ruth Lilly Medical Library
AGA Medical Position Statement: Guidelines for the Evaluation of Food Allergies
Clinical Aspects of Gastrointestinal Food Allergy in Childhood
Effect of six-food elimination diet on clinical and histological outcomes in eosinophilic esophagitis
Cincinnati Center for Eosinophilic Disorders at Cincinnati Children's Hospital
Quote from Textbook of Gastroenterology (2003, emphasis mine):
"Small amounts of antigenic macromolecules normally penetrate the gastrointestinal mucosal barrier and reach the systemic circulation, occurring more in early life and in conditions causing disruption of the mucosal defenses".
Note: Exposure to gluten increases intestinal permeability in everyone, although there tends to be a greater increase in people with CD (References 1 2). Increased intestinal permeabilitly may make people with CD more likely to have developed other food intolerances and allergies
Role of the Intestinal Barrier in Inflammatory Bowel Disease
includes a discussion of probiotics
Probiotic VSL#3 protects the epithelial barrier...in a murine model
Vitamin D has been demonstrated to play an important role in
intestinal mucosal barrier maintenance:
Novel role of the Vitamin D receptor in maintaining the integrity of the intestinal mucosal barrier
Protective Effect of 1,25-Dihydroxy Vitamin D3 on Pepsin-Trypsin-Resistant Gliadin-Induced TightJunction Injuries.
Celiac Disease and Recurrent Pancreatitis
This article shows the connection between Celiac Disease,
Sphincter of Oddi Dysfunction (aka papillary stenosis) and pancreatitis
Risk of Pancreatitis in 14,000 Individuals with Celiac Disease
Sphincter of Oddi Dysfunction: Diagnosis and Treatment
Treatment of Sphincter of Oddi Dysfunction by ERCP with manometry/sphincterotomy
is best done at a specialist such as Stuart Sherman at Indiana University
