Since not everyone has access to Medscape:

Antibiotic Exposure and the Development of Coeliac Disease

Background The intestinal microbiota has been proposed to play a pathogenic role in coeliac disease (CD). Although antibiotics are common environmental factors with a profound impact on intestinal microbiota, data on antibiotic use as a risk factor for subsequent CD development are scarce.

Methods In this population-based case–control study we linked nationwide histopathology data on 2,933 individuals with CD (Marsh stage 3; villous atrophy) to the Swedish Prescribed Drug Register to examine the association between use of systemic antibiotics and subsequent CD. We also examined the association between antibiotic use in 2,118 individuals with inflammation (Marsh 1–2) and in 620 individuals with normal mucosa (Marsh 0) but positive CD serology. All individuals undergoing biopsy were matched for age and sex with 28,262 controls from the population.

Results Antibiotic use was associated with CD (Odds ratio [OR] = 1.40; 95% confidence interval [CI] = 1.2 7–1.53), inflammation (OR = 1.90; 95% CI = 1.72–2.10) and normal mucosa with positive CD serology (OR = 1.58; 95% CI = 1.30–1.92). ORs for prior antibiotic use in CD were similar when we excluded antibiotic use in the last year (OR = 1.30; 95% CI = 1.08–1.56) or restricted to individuals without comorbidity (OR = 1.30; 95% CI = 1.16 – 1.46).

Conclusions The positive association between antibiotic use and subsequent CD but also with lesions that may represent early CD suggests that intestinal dysbiosis may play a role in the pathogenesis of CD. However, non-causal explanations for this positive association cannot be excluded.

Karl Mårild, Weimin Ye, Benjamin Lebwohl, Peter HR Green, Martin J Blaser, Tim Card, Jonas F LudvigssonDisclosures
BMC Gastroenterol. 2013;13(109) 
#antibiotics   #celiac  

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Intestinal Biopsy no longer required for Celiac Diagnosis.

Villi under an electron microscope  © 2011 S. Schuller, Wellcome Images, used under Creative Commons license.
Villi under an electron microscope © 2011 S. Schuller, Wellcome Images, used under Creative Commons license.
Published today in the BMC Gastroenterology, finally a conclusion that might help people get to an understanding of their reaction.

This review study gathered information from 40 different studies, all looking to see whether the invasive biopsy is truly necessary for celiac diagnosis.

Their conclusion?

“There is no single test — not even jejunal biopsy — that can conclusively diagnose or exclude CD in every individual. Therefore, we propose the following two-step diagnostic procedure: The first step is the combined, simultaneous determination of IgA anti-dpgli and IgG anti-dpgli + IgA anti-tTG and/or EMA. The vast majority of patients will have either three positive or three negative results, obviating the need for a biopsy. The second step, jejunal biopsy, should be performed only in patients with discordant antibody results (i.e., in patients whose CD status cannot be classified by antibody tests alone). In any case, effects of a gluten-free diet must be controlled.”

Take Home Message:Celiac Diagnosis

If you have symptoms, or first degree relatives who have celiac disease, convince your doctor to run a complete celiac blood panel to see. The needed tests are IgG anti-dpgli + IgA anti-dpgli + IgA anti-tTG. No longer is the anti endomysial antibody considered essential for diagnosis.

For all the Geeky folks like me, here is the original research and citation

Time to think of Summer Camp

Girls at Camp

If you have a child, March is when you begin searching for the perfect place for them to go to Summer Camp.

When you have a Celiac or Gluten-Intolerant child the planning can be far more complex. Guidance to find a Summer Camp for Celiac children becomes a Google Search of hours long duration.

Make it easier on yourself this year, join the National Foundation for Celiac Awareness on Thursday, March 14, 2013 at 8:30 p.m. Eastern/5:30 p.m. Pacific.  for a planning seminar.

There is even a possibility of winning one of 10 Camp Scholarships sponsored by Rudi’s Gluten-Free Bakery

[Neurological disorders associated with gluten sen… [Rev Neurol. 2011] – PubMed result

Rev Neurol. 2011 Sep 1;53(5):287-300.

[Neurological disorders associated with gluten sensitivity].

[Article in Spanish]

Hernandez-Lahoz C, Mauri-Capdevila G, Vega-Villar J, Rodrigo L.


Hospital Universitario Central de Asturias, 33006 Oviedo, Espana.


Gluten sensitivity is a systemic autoimmune disease that occurs in genetically susceptible individuals on ingesting gluten. It can appear at any age, then becoming a permanent condition. It is more frequent in women, as happens with other autoimmune diseases. Celiac disease is the intestinal form and the most important manifestation among a set of gluten-induced autoimmune pathologies that affect different systems. Neurological manifestations of gluten sensitivity, with or without enteropathy, are also frequent, their pathogenesis including an immunological attack on the central and peripheral nervous tissue accompanied by neurodegenerative changes. The clinical manifestations are varied, but the most common syndromes are cerebellar ataxia and peripheral neuropathy. Finally, gluten sensitivity is associated to a varying degree, with other complex diseases and could influence their evolution. The early detection of cases of gluten sensitivity with neurological manifestations and subsequent treatment with the gluten-free diet could provide remarkable benefits to the patients.



via [Neurological disorders associated with gluten sen… [Rev Neurol. 2011] – PubMed result.

Birth, the beginning of Celiac?

Infants Delivered By Cesarean May Be More Likely to Develop Celiac Disease

Baby, Birth of Celiac?

Cesarean delivery is related to a higher incidence of pediatric celiac disease, according to an article published online May 17 in Pediatrics.…

After birth, an infant’s environment shifts from a sterile space to one colonized by bacteria. Almost immediately, microbial products and live bacteria can be seen, but only in a part of the baby’s intestine. The arrival of solid food several months later establishes a complex bacterial flora throughout the entire bowel. The composition of the flora has been shown to vary significantly depending on whether the birth was vaginal or cesarean.

“Differences in the microbial flora and impaired priming of the enteric epithelial surface in individuals who are born by cesarean delivery might therefore contribute to inflammatory conditions of the intestinal mucosa later in life,” write lead author Evalotte Decker, from the Department of Pediatrics, Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Germany, and colleagues. “Indeed, the rate of cesarean delivery as well as the incidence of [inflammatory bowel disease] and celiac disease have increased in recent decades.”

The investigators conducted a retrospective, multicenter, case-control study of 1950 pediatric patients to examine a possible relationship between inflammatory intestinal disease and cesarean delivery. From May 2008 through May 2009, 1088 of the child and adolescent subjects received treatment at gastrointestinal outpatient clinics for any 1 of the following: Crohn’s disease, ulcerative colitis, celiac disease, or other gastrointestinal issues. The remaining 862 patients served as the control group.

The study authors gathered information that included the participants’ disease type, method of birth, gestational age at delivery, complications after birth, and breast-feeding. Their results follow.

  • Between 1991 and 2007, the rate of cesarean delivery rose from 15% to 30% (1.2% increase per year; odds ratio [OR], 0.96; 95% confidence interval [CI], 0.94 – 0.99; P = .015).
  • A substantially greater rate of cesarean delivery was discovered in children with celiac disease (27.6% vs 17.2% for the control group; OR, 1.83; 95% CI, 1.18 – 2.85).
  • Significant increases in cesarean delivery rates were not found in children with Crohn’s disease (19.3%; OR, 1.14; 95% CI, 0.83 – 1.58), ulcerative colitis (15.4%; OR, 0.87; 95% CI, 0.55 – 1.38), or other gastrointestinal conditions (OR, 1.03; 95% CI, 0.62 – 1.69).
  • Adjusting for age, sex, complications after birth, and duration of breast-feeding using binomial logistic regression underscored the relationship between cesarean delivery and celiac disease (OR, 1.80; 95% CI, 1.13 – 2.88; P = .014) but not Crohn’s disease (OR, 1.27; 95% CI, 0.87 – 1.84; P = .208) or ulcerative colitis (OR, 0.89; 95% CI, 0.51 – 1.54; P = .673).

“Our results demonstrated a significant and previously undescribed association between cesarean delivery and celiac disease,” the authors write. “In our study, patients with [Crohn’s disease or ulcerative colitis] were not more likely than healthy control subjects to be born by cesarean delivery.”

The results also showed that celiac disease was related to a higher rate of breast-feeding (OR, 1.99; 95% CI, 1.12 – 3.51) compared with the control participants (P = .015).

There were no explicitly stated limitations to the study, but the investigators did note that future studies would be strengthened by the inclusion of several additional factors, including socioeconomic status, birth order, previous cesareans, hygiene status, smoking during pregnancy, family history, genetic testing, and initial disease presentation.

The study authors also said that further research might yet reveal a relationship between cesarean delivery and more inflammatory bowel diseases. It would also be useful in corroborating their findings regarding the association between cesarean delivery and celiac disease.

“Although this association needs to be confirmed in a larger investigation, our results indicate that alterations of the intestinal flora observed after cesarean delivery might impair the establishment of the host–microbe homeostasis and intestinal mucosal integrity and contribute to the pathogenesis of enteric inflammatory diseases,” the authors write.

The German Research Foundation and the German Ministry for Science and Education supported this study. The study authors have disclosed no relevant financial relationships.

Pediatrics. Published online May 17, 2010.