Body composition and calcium metabolism in adult treated coeliac disease

Article Abstract:

Celiac disease is an intestinal malabsorption syndrome characterized by intestinal bleeding, diarrhea, malnutrition, and disordered calcium metabolism. By the time patients with this condition are diagnosed and treatment is instituted, they have often suffered significant weight loss. Removal of the dietary constituent gluten can usually control the symptoms of celiac disease. However, it is not known whether satisfactory treatment by dietary means completely restores normal body composition and calcium metabolism. To further evaluate the effects of treatment on the restoration of normal body composition and calcium metabolism in patients with celiac disease, a study was undertaken in which 22 patients, aged 20 to 70 years, underwent body composition analysis and determination of bone mineral content (an important endpoint directly affected by altered calcium metabolism). When compared with an age-matched group of healthy control subjects, patients with treated celiac disease showed a 30 percent reduction in body fat, and about a 10 percent decrease in bone mineral content. Decreases were also seen in blood levels of albumin, vitamin D binding protein, and iron. Levels of these indices in treated celiac disease patients were between 6 and 22 percent lower than those of controls. Other aspects of blood chemistry were not different between groups. Individuals who have chronic reductions in bone mineral content suffer from increased susceptibility to bone fractures; this may hold true for patients with celiac disease in spite of treatment that reduces or eliminates outward symptoms of the disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Body composition, Osteal manifestations of general diseases, Osteal symptoms, Calcium in the body, Calcium (Nutrient)

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Coeliac disease and malignancy of the duodenum: diagnosis by endoscopy, successful treatment of the malignancy, and response to a gluten free diet

Article Abstract:

Celiac disease is a gastrointestinal disorder characterized by malabsorption, malnutrition, diarrhea, intestinal bleeding, and decreased blood levels of calcium. Patients with celiac disease are inordinately sensitive to dietary gluten products, and often respond favorably to a gluten-free diet. Persons with celiac disease have a higher incidence of lymphoma (cancer of the lymphatic system) than the general population. In celiac disease patients, the cancer usually afflicts the gastrointestinal system and is widely disseminated at the time of diagnosis, resulting in a poor prognosis for these patients. A case is reported of a 64-year-old man who sought medical treatment for steatorrhea (excessive fat in the stools). He had a five-year history of abdominal pain and fatty stools. Endoscopy (a diagnostic technique for viewing the interior of the gastrointestinal tract by introducing a flexible fiber-optic viewing device) did not reveal any abnormalities, nor did computed tomographic imaging (CT scan) of the abdomen. Radiological viewing of the intestinal tract with barium indicated the presence of a tumor; this was surgically removed and was found to be malignant. Chemotherapy followed the surgery, and the patient was maintained on a gluten-free diet. The patient remained alive and well for 28 months following surgery, until he died of an unrelated cause (fractured skull). This case represents one of the earliest diagnoses of celiac disease-related malignant tumors, and its successful treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Gastrointestinal cancer, Digestive system cancer

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Small bowel enema in non-responsive coeliac disease

Article Abstract:

Celiac disease is an intestinal disorder characterized by malabsorption, diarrhea, malnutrition, bleeding, and low blood calcium levels. It can sometimes be treated by the elimination of gluten (a vegetable protein) from the diet, but this is not effective in all cases. However, non-responsive celiac disease, in which dietary therapy is ineffective, is fairly uncommon, and quite difficult to distinguish from a patient's failure to carefully follow the gluten-free diet. Currently, diagnosis of non-responsive disease must be made by means of expensive, time-consuming, and unpleasant (to the patient) test procedures. A simple, effective means of diagnosing non-responsive celiac disease is presented, based on findings in 50 control subjects, 15 celiac disease patients in remission (seven untreated and eight who responded to a gluten-free diet), and nine patients who were confirmed non-responders. Barium enema (a radiological technique for visualizing the gastrointestinal tract) of the jejunum and ileum (sections of the small intestine) was performed. A characteristic decrease in the number of jejunal folds and an increase in the number of ileal folds were seen in 88 percent of the non-responsive patients, in 14 percent of the untreated celiac patients, and in none of the good responders or control patients. This reversal of the normal jejuno-ileal pattern of folds is a good predictor of patients who will not respond to dietary treatment, and who are likely to develop major complications. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Abnormalities, Intestine, Small, Small intestine, Gluten-free diet, Enteroclysis

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