New study reveals almost 20% of celiac children may not heal on a gluten-free diet – gluten free homestead

Last week as I was glancing through my Google news feed on celiac disease, I came across three headlines that startled me. Bronchoscopy procedure I had to read each headline twice just to make sure I was reading them right.

These headlines, however, actually reflect a rather poor analysis of a recent (Nov/16) study done by the MassGeneral Hospital for Children (MGH) that found that 19% of celiac children still continued to show intestinal damage after at least one year on a GFD.

Let’s see what we can learn from the MGH study, and then see if we can make sense of these headlines. Bronchoscopy with bal The Objective In The Recent MassGeneral Hospital Study On CD

This past November, the Journal of Pediatric Gastroenterology & Nutrition released a study by researchers from MGH entitled Value of IgA tTG in Predicting Mucosal Recovery in Children with Celiac Disease on a Gluten Free Diet.

You can read the study here.

Ebus bronchoscopy Click on “article as a PDF” to get the whole text of the study. What is bronchoscopy The study had two primary objectives 1. Fibre optic bronchoscopy To determine the rate of mucosal recovery in pediatric patients with celiac disease on a GFD

Notice that the researchers wanted to determine the rate of intestinal healing in children with CD on a GFD, not whether they healed at all. Colonoscopy video youtube 2. What is a bronchoscopy To determine whether IgA tissue transglutaminase (tTG) correlates with mucosal damage at the time of a repeat endoscopy with duodenal biopsy in these patients

Clinicians have also used the test as a means for measuring the amount of mucosal healing after the start of a GFD. Colonoscopy deaths per year The return to a normal tTG titer was thought to be suggestive of intestinal mucosal recovery.

After an initial tTG test and endoscopy, a follow-up tTG and endoscopy was performed on all children within 1 -12 years of being on a GFD. Bronchoscopy test The mean result for follow-up endoscopy was 2.4 years.

While researchers know that up to 33% of adult celiacs continue to show mucosal damage after going on a GFD this degree of delayed healing was not expected in children.

While researchers found that tTG was accurate in initially identifying CD, it was not a good indicator of how well the intestinal mucosa was healing in CD patients.

Apparently, because a large percentage of children didn’t show mucosal healing at least 2 years after a GFD, researchers can no longer assume that celiac children heal significantly better than celiac adults.

Echoing Dr. Bronchoscopy biopsy Leonard’s call for a more aggressive approach to detect mucosal healing in celiac pediatric patients, Dr. Bronchoscopy complications Fasano announced that MGH is changing its clinical approach. Post colonoscopy instructions He states,

We assumed that healing would occur once a patient was put on the gluten-free diet. Bronchoscopy images Now that we have learned that this is not the case for all celiac patients, we are changing our clinical practice by repeating the endoscopy after one year of the implementation of the gluten-free diet.

Since the tTG test was found to be an inaccurate measure of the rate of mucosal healing, researchers need a more accurate way to discover how much healing is taking place. Post colonoscopy care This is essential for follow-up treatment.

Previously, clinicians recommended an initial single endoscopy with biopsy at diagnosis and follow-up blood testing (tTG) to monitor recovery of the intestinal mucosa.

Now, however, MGH recommends that until a better non-invasive means that reveals an accurate picture of intestinal healing is developed, the highly accurate endoscopy should be performed on all celiac patients one-year post GFD.

Since only 103 patients were studied we don’t know if the 19% number would change if a larger number of patients were studied. How long does a bronchoscopy take It’s possible that the percentage could be higher or lower.

Some proposed reasons for persistent mucosal damage are a lack of adherence to a GFD, cross-contamination of gluten in the diet, persistent inflammation, persistent leaky gut, or a disruption of the intestinal microbiome.

While I know it wasn’t the scope of this study to investigate the possible nutritional deficiencies in those who had persistent damage, I still would be curious to know if there were any.

Were there any deficiencies revealed on blood panels that might reveal malabsorption problems that could be responsible for the persistent damage? 3. Bronchoscopy video Did The 20% Who Displayed Delayed Healing Maintain A Pro or Anti-Inflammatory Diet?

Standard GFDs are not necessarily anti-inflammatory. Bronchoscopy indications Simply replacing gluten-containing foods with highly processed non-gluten grains and other foods might encourage further inflammation.

Again, I know a dietary investigation was not within the scope of this study, but I would be curious to know if diet plays a part in persistent mucosal damage. Colonoscopy procedure code 4. Colonoscopy surgery What Is The Next Clinical Step If Compliance To A GFD Is 100% And There Is Persistent Mucosal Damage?

I’m sure CD researchers all over the world are trying to answer these questions. Colonoscopy deaths I pray they find answers soon. Colonoscopy biopsy results Evidence-Informed Expert Recommendations for the Management of Celiac Disease in Children

Even If you don’t have a child with celiac disease but you know someone who does, send it along to them. Colonoscopy aftercare Even if they’ve already read them, they’ll thank you for caring and understanding.

The MGH study did find that a prolonged GFD contributed to the healing of 80% of pediatric celiac patients’ intestinal mucosa. Colonoscopy findings So this title is just clearly inaccurate. Colonoscopy definition Does a GFD in children promote poor intestinal health?

Now add to this the many celebrities touting the health benefits of shunning gluten, and you have a significant number of non-celiac people who don’t eat wheat bread.