CD and GERD

[annelb]

Sometimes I want to ignore articles like this one. It found no correlation between CD and gluten. Perhaps they should have been looking for gluten sensitivity instead of CD. Interesting is that the people in the study had reflux esophagitis diagnosed by endoscopy. The controls were not people without symptoms. The controls had heartburn without an abnormal endoscopy. Because the IgA AGA and IgG AGA tests were similar in both groups it was felt this was not significant. No patient had a positive EMA.

Again, are the missing those with gluten sensitivity? Too bad the study did not include a trial of a GF diet to see if symptoms resolved.

After going GF I was able to stop taking Pepcid every day. I was able to sleep flat again. After going GF my son says his heartburn disappeared.
Anne


http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17075989&query_hl=1&itool=pubmed_docsum
World J Gastroenterol. 2006 Nov 7;12(41):6707-10. Links
Levels of serologic markers of celiac disease in patients with reflux esophagitis.Bagci S, Ercin CN, Yesilova Z, Ozcan A, Degertekin B, Dagalp K.
Department of Gastroenterology, Gulhane School of Medicine, Etlik 06018 - Ankara, Turkey. yesilovaz@yahoo.com.

AIM: To investigate the prevalence of celiac disease serologic markers (antigliadin IgA, IgG, and anti-endomysial IgA) in patients with reflux esophagitis and to detect the relationship between reflux esophagitis and celiac disease (CD). METHODS: This study was performed prospectively between January 2003 and January 2004. Sixty-eight adult reflux esophagitis patients and 40 people as control group for symptoms related with gastrointestinal system were enrolled in this study. The diagnostic work-up included an accurate medical history with gastrointestinal symptoms, routine laboratory measurements, the detection of antibodies against gliadin (IgA and IgG) and endomysium (IgA), and an upper endoscopy with postbulbar biopsy. RESULTS: IgA-AGA and IgG-AGA were positive at 8.8% and 10.3% in patients with reflux esophagitis. In control group, it was found that 10% people had positive IgA-AGA, and 7.5% people had positive IgG-AGA. There was no significant relationship between patients and control group regarding positive IgA-AGA and IgG-AGA. The patients and persons in control group had no positive IgA-EMA. On postbulbar biopsies, no finding was detected concerning celiac disease. There were no symptoms and signs for gluten enteropathy in patients and control group. CONCLUSION: This review supports that an association does not exist between celiac disease and reflux esophagitis. We think these diseases exist independently from each other.

PMID: 17075989 [PubMed - in process]

[GFPaperdoll]

Anne, a guy in my office has two DQ1 genes and GERD, he takes meds for it, I know he has gluten intolerance - he has a few other issues :rolleyes:

(I can make em take the enterolab test but ya know when they want to keep their head stuck in the sand while popping those pills... you have to let them lead their own life...)

[aklap]

After going GF I was able to stop taking Pepcid every day. After going GF my son says his heartburn disappeared.

Me three! :)

[Zonulin]

Yeah, but:

Reflux oesophagitis in adult coeliac disease: beneficial effect of a gluten free diet.Cuomo A, Romano M, Rocco A, Budillon G, Del Vecchio Blanco C, Nardone G.
Dipartimento di Internistica Clinica e Sperimentale-Gastroenterologia and CIRANAD, Seconda Universita di Napoli, Napoli, Italy.

BACKGROUND: Coeliac disease patients show a number of gastrointestinal motor abnormalities, including a decrease in lower oesophageal sphincter pressure. The prevalence of endoscopic oesophagitis in these subjects however is unknown. Aim: To evaluate whether untreated adult coeliac patients had an increased prevalence of reflux oesophagitis and, if so, to assess whether a gluten free diet exerted any beneficial effect on gastro-oesophageal reflux disease (GORD) symptoms. PATIENTS AND METHODS: We retrospectively studied 205 coeliac patients (females/males 153/52, median age 32 years) who underwent endoscopy for duodenal biopsy and 400 non-coeliac subjects (females/males 244/156, median age 37 years) referred for endoscopy for upper gastrointestinal symptoms. Each patient was given a questionnaire for evaluation of GORD symptoms prior to and 4-12 months after endoscopy. Coeliac patients were given a gluten free diet. Oesophagitis patients of both groups, following an eight week course of omeprazole, were re-evaluated for GORD symptoms at four month intervals up to one year. Significance of differences was assessed by Fisher's exact test. RESULTS: Oesophagitis was present in 39/205 (19%, 95% confidence interval (CI) 13.8-25.0%) coeliac patients and in 32/400 (8%, 95% CI 5.5-11.1%) dyspeptic subjects. At the one year follow up, GORD symptoms relapsed in 10/39 (25.6%, 95% CI 13-42.1%) coeliacs with oesophagitis and in 23/32 (71.8%, 95% CI 53.2-86.2%) non-coeliac subjects with oesophagitis. CONCLUSION: Coeliac patients have a high prevalence of reflux oesophagitis. That a gluten free diet significantly decreased the relapse rate of GORD symptoms suggests that coeliac disease may represent a risk factor for development of reflux oesophagitis.
PMID: 12631661 [PubMed - indexed for MEDLINE]
They're not looking for gluten sensitivity because they don't acknowledge its existence (as we all, unfortunately, know). :) For us, gluten sensitivity is the big fat elephant in the living room. And the medical community is asking us, "WHAT elephant?"

Karen

[annelb]

Doctor Gluten, also known as Dr. Ford, sees a connection between GORD and gluten. Go here to download his pdf about children and GORD http://www.doctorgluten.com/dls/fdls/DGfreedownloads.htm There is also a pdf of symptoms.

He uses GORD instead of GERD as Dr. Ford is in New Zeland and puts an "o" at the beginning of "eophageal"

I wonder if his positive results would be even better if he looked for all the foods that may be causing reactions in a child?
Anne

[Zonulin]

He uses GORD instead of GERD as Dr. Ford is in New Zeland and puts an "o" at the beginning of "eophageal" - Anne

Oooo - website looks good - I will have to delve into this further. There's still an oelephant in the living room...

Karen

[jcc]

GERD is one of the symptoms I lost when going gluten free.

Cara

[lmb3]

I lost it too, after going GF. However, my son wasn't diagnosed with it until he was on on GF diet for 3.5 years and is currently taking meds for it. Of course, he refuses to give up his GF pepperoni sandwiches! :o

[klasyjo]

Mine has slowed way down but I still consume dairy products. Part of the reason why I'm trying to get the lactose tolerance test done at my annual. Thanks for the great info!

[annelb]

I was surprised to see that Dr. Weil mentioned wheat/gluten as a cause of GERD.
Keep a food log to track the foods and beverages that make your symptoms worse. Certain foods and beverages can compromise the esophageal sphincter including peppermint, citrus, caffeine and alcohol. Other foods have also been implicated - tomatoes, garlic, dairy products and high-fat meals. Wheat and other grains containing gluten (oats, barley and rye) are problems for some people. Learn what affects you.
http://www.drweil.com/drw/u/id/TIP02143
Anne

[jcc]

Keep the good info coming :). I still have to make a page with GERD info in TGF. Not sure when I will get to it...not for at least a few weeks..as this new puppy is WORK!

Cara

[canoe]

Very interesting. I am wondering if the other person in the household would be willing to try a GF diet since he has frequent heartburn. I will try to approach this with him.

Thanks for posting, Anne.

Marilyn

[annelb]

Ron Hoggan wrote "The currently common view that celiac disease is a serious illness, while disregarding gluten sensitivity, is dangerous to gluten sensitive patients."
http://www.celiac.com/st_prod.html?p_prodid=1142&sid=91hH9H1ja7QJCRj-56107588939.7e I have to wonder how many of those with heartburn but not CD would have improved on a GF diet?

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17235704&query_hl=6&itool=pubmed_docsum
Dig Dis Sci. 2007 Jan 20; [Epub ahead of print] Links
Prevalence of Silent Celiac Disease in Patients with Dyspepsia.Ozaslan E, Akkorlu S, Eskioglu E, Kayhan B.
Department of Gastroenterology, Numune Education and Training Hospital, Ileri Mah. Mektep Sok. No: 7/10, Kurtulus, 06660, Ankara, Turkey, er72@hotmail.com.

Celiac disease (CD) has become more common than in the past, although it frequently remains undetected for long periods of time. One reason for this is failure by health care professionals to recognize the variable clinical manifestations of CD and to perform the appropriate tests to make the diagnosis. Although dyspepsia may be part of a clinical spectrum in CD patients, there are scarce data about its prevalence in silent CD. We aimed to determine the prevalence of CD in otherwise healthy dyspeptic patients by means of serologic screening followed by endoscopic biopsies if appropriate. Anti-endomysium antibody assay was positive in 3 of 196 patients. All 3 were female, ages ranged from 19-52 years (mean +/- SD age, 36+/-16 years). Duodenal biopsies were compatible with CD in all, whereas abnormal endoscopic findings were noted in 2. Therefore, a 1.5% prevalence of CD was observed in this study group. The odds ratio for CD was 2.57 (95% confidence interval) in comparison with the general population. CD should be kept in mind as a cause of dyspepsia during clinical activities. The association between these 2 conditions is, at most, weak, but a gluten-free diet may still bring symptomatic relief for dyspeptic symptoms in CD. During endoscopic examination for dyspepsia, if indicated, endoscopists should carefully inspect the duodenum for CD findings. Although routine serologic screening can not be recommended, it may be appropriate for the patients with refractory dyspepsia, especially females.

PMID: 17235704 [PubMed - as supplied by publisher]