Stanford pediatric gastroenterologist responds to your questions on celiac disease

Below I discuss future treatment options that may become available, but still only considered within research frameworks at this time. Mylea Charvat asks: With celiac will I ever be able to eat regular pastas and breads again? Is there any research into medication to help those diagnosed with celiac disease digest and tolerate gluten? I wish there were better news for the here and now. Unfortunately, as you know, a strict gluten-free diet a for now a is the only treatment option for celiac disease. Regular pastas and breads are definitely hard to give up, especially if you really enjoy them. With that said, many laboratories around the world are evaluating different strategies to offer celiac patients more therapeutic options in the future. One hopeful approach is aglutenase therapya where an enzyme could break down the gluten and render it non-toxic. Other working ideas include: blocking the immune reaction (i.e., auto-antibodies) through an ingestible polymeric resin, adesensitizinga the bodyas immune system response to gluten via serial protein-based injections and developing a celiac vaccine. Looking ahead, it is conceivable that celiac patients will one day be able to eat gluten-containing foods, but definitive alternatives to gluten avoidance are not yet ready for general consumer use. Antonio Ruben Murcia Prieto asks: What aboutAoats for celiac disease? The topic of oats is very much an evolving discussion among celiac experts. Generally, oats are an excellent source of good nutrients, including vitamins, minerals and antioxidants, and dietary fiber, such as soluble beta-glucans. They are high in protein, and are even thought to help maintain steady insulin levels. The working idea is that the biochemical nature of oats is gluten-free, but the manufacturing process of oats contaminates it with a common cereal protein called prolamins , which are found in wheat, barley and rye containing seeds that celiac patients have to avoid.

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Celiac Disease: Getting to Know the Gastroenterologist

Find out how to prepare and what to expect at your first visit. Medically reviewed by Christine Wilmsen Craig, MD If you suspect that you have celiac disease (also known as celiac sprue) but have not yet been diagnosed, youll need to see a gastroenterologist (GI). A gastroenterologist is a medical doctor who specializes in the digestive tract, which includes the stomach, intestines, liver, and pancreas. Your gastroenterologist will run the tests necessary to diagnose celiac disease and advise you on what to do next. Ritu Verma, MD, director of the Children’s Celiac Center at Children’s Hospital of Philadelphia and the section chief of gastroenterology, hepatology, and nutrition, tells you what to expect from your first visit. Your First Gastroenterologist Visit: What to Expect Your first visit to a gastroenterologist will be pretty similar to a regular doctor visit, Dr. Verma explains. The GI will take a medical history and do a complete physical exam, and possibly a rectal exam if youre experiencing bloody stools. If celiac disease is suspected, the gastroenterologist will order blood tests (known as a celiac panel) to help diagnose celiac disease. It can take between three days and two weeks to receive the results, Verma says. Then the next step is to schedule an endoscopy. An endoscopy involves passing a small tube with a camera on the end of it into the mouth, through the stomach, and into the small intestine. Biopsies (tissue samples) can be taken of the small intestine to confirm the diagnosis of celiac disease. Your First Gastroenterologist Visit: How to Prepare To prepare for your first visit to the gastroenterologist: Dont change your diet. The most important thing, if you think you might have celiac disease, is to not modify your diet. If you start a gluten-free diet beforehand, celiac testing wont be accurate, Verma says.

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Gastroenterologist Offers Tips For Choosing A Probiotic

Raymond offers her tips for choosing a probiotic: – Assess your health needs: There is a very large variety of strains of probiotics available and some are better suited to assist with certain problems than others. “If you’re someone who simply suffers from occasional constipation , then a probiotic yogurt may do the trick,” advises Dr. Raymond. “However, if you suffer from chronic, serious conditions, a supplement may be more appropriate, as more serious conditions require a probiotic dosage of at least 1 billion live micro-organisms in order to have an effect.” Foods cannot sustain a number of micro-organisms that high. – Look for scientific research. As more U.S. physicians are starting to accept probiotics as a legitimate therapy, more studies are being done with them. “For example, Saccharomyces boulardii , a yeast-based probiotic strain commonly sold under the brand name Florastor , has been shown in studies to provide significant benefits in managing even severe illnesses such as C. diff-associated disease, Crohn’s disease and Ulcerative Colitis,” says Dr. Raymond. Talk to your doctor to find out about the available science that supports the use of probiotics. – Consider your lifestyle. The form in which a probiotics is packaged may be integral in how successfully you take it. “If you are a frequent traveler looking to combat issues like traveler’s diarrhea , a probiotic that needs refrigeration may not be appropriate for you,” suggests Dr.

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