Document Detail

Dietary analysis in symptomatic patients with coeliac disease on a gluten-free diet: the role of trace amounts of gluten and non-gluten food intolerances.
MedLine Citation:
PMID:  10499479     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Whereas many people with coeliac disease (CD) are asymptomatic when consuming a gluten-free diet (GFD), a proportion continues to experience symptoms. The reasons for this are unclear. METHODS: Thirty-nine adult members of The Coeliac Society of New South Wales, all of whom had persistent gastrointestinal symptoms despite adhering to a GFD, were evaluated. Dietary analysis indicated that 22 (56%) were consuming a GFD as defined by the WHO/FAO Codex Alimentarius (Codex-GFD), in which foods containing up to 0.3% of protein from gluten-containing grains can be labelled as 'gluten free'. The remaining 17 were following a no detectable gluten diet (NDG)-GFD, as defined by Food Standards Australia. All subjects were required to follow a NDG-GFD during the study. Those in whom symptoms persisted after changing from a Codex-GFD and those who entered the study already on a NDG-GFD began an elimination diet followed by open and double-blind challenges to identify specific non-gluten food or food chemical intolerances. RESULTS: Of 22 patients who switched to a NDG-GFD symptoms resolved in 5 (23%) and were reduced in 10 others (45%). Thirty-one subjects commenced the elimination diet. Symptomatic improvement was experienced in 24 (77%). Subsequent food or food chemical challenges resulted in a mean of five positive challenges per individual. Diarrhoea was the most commonly provoked symptom, followed by headache, nausea, and flatulence. Symptoms were especially provoked by amine, salicylate and soy. CONCLUSION: The consumption of trace amounts of gluten, traditionally allowed in a Codex-GFD, may be responsible for the continuing symptoms seen in some patients with CD. Further investigation for non-gluten food intolerances should follow if symptoms persist after adherence to a NDG-GFD.
K B Faulkner-Hogg; W S Selby; R H Loblay
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  34     ISSN:  0036-5521     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-11-02     Completed Date:  1999-11-02     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  NORWAY    
Other Details:
Languages:  eng     Pagination:  784-9     Citation Subset:  IM    
Dept. of Clinical Immunology, and AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
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MeSH Terms
Amines / adverse effects
Celiac Disease / complications*,  diet therapy*,  pathology,  physiopathology
Diet Records
Food Hypersensitivity / complications*,  diagnosis*
Food, Formulated
Glutens / adverse effects*
Intestine, Small / pathology
Middle Aged
Milk / adverse effects
Nutrition Assessment
Panicum / adverse effects
Salicylates / adverse effects
Reg. No./Substance:
0/Amines; 0/Salicylates; 8002-80-0/Glutens

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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