A More Livable Life With Celiac Disease?
Efforts to help include new medication and diagnostic techniques

(HealthDay News) -- For some people, a big bagel is less a delicious treat and more a digestive bomb. That's the case for those who have celiac disease.

But research discoveries are helping people with the disease treat it, and helping doctors diagnose those who have it but just don't know it.

Celiac disease is an autoimmune disorder that damages the small intestine and interferes with absorption of nutrients from food, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. People who have celiac disease can't tolerate gluten, a protein in wheat, rye and barley.

Avoiding gluten means more than avoiding baked goods and pasta. Gluten also can be in medicines, vitamins and lip balms.

"At this time, the only effective treatment for celiac disease is a lifelong gluten-free diet, a lifestyle that is difficult for many patients to manage," Dr. Peter H. Green, of the Columbia University Medical School , said in a prepared statement. "Unfortunately, many people are unaware that they have celiac disease, and if left untreated, it can be life-threatening."

Recently completed studies, and those still under way, "will hopefully lead to improved diagnosis, prevention, treatment and quality of life for this disease," Green said.

In one study, researchers found that a medication called AT-1001 may protect people with celiac disease from exposure to gluten. The drug prevents gluten from crossing the intestinal mucosa.

The study of 86 people found that those who were given gluten and AT-1001 had fewer symptoms of gluten toxicity than those who were given gluten and a placebo. The researchers are now conducting a larger test of the drug.

"Even allowing for the fact that people in clinical trials may practice healthier habits, the fact that all of the groups showed improvement in the first week of the study is significant," said the study's author, Dr. Daniel Leffler, clinical research director at the Celiac Disease Center at Beth Israel Deaconess Medical Center in Boston .

Another study that focused on better diagnosing of people with celiac disease concluded that the criteria used to diagnose the disease might be too stringent.

Experts say it can be tough to diagnose celiac disease because its symptoms are often similar to symptoms of irritable bowel syndrome, inflammatory bowel disease and more.

This study, though, focused on the levels in the blood of certain autoantibodies, proteins that react against the body's own cells or tissues, that have been found in higher-than-normal levels in people with celiac disease.

It involved 145 people suspected of having celiac disease. Of that group, 71 were found to be endomysial antibody positive, and 48 of the 71 met the current criteria for celiac disease diagnosis. The remaining 23, who didn't meet the criteria, were divided into groups, with those in one group eating a regular diet and the others eating a gluten-free diet.

After a year, those on the gluten-free diet had no symptoms or antibodies. People who'd been eating the regular diet had symptoms and antibodies, but when they eliminated gluten from their diet, they, too, became symptom-free, the study found.

Other research also is under way that could increase the odds of a diagnosis. One study, funded by the National Institutes of Health, involves the testing of a diagnostic technique called capsule endoscopy. The person being tested swallows a capsule that contains a tiny video camera, and the camera then records images of the small intestine.

The hope fueling celiac research of all kinds is to be able to "treat patients before they begin to experience the most severe symptoms and signs of the disease," Dr. Markku Maki, a pediatrics professor and a member of the Celiac Disease Study Group at the University of Tampere in Finland, said in a prepared statement.

On the Web

To learn more about celiac disease, visit the American Academy of Family Physicians.

SOURCES: HealthDay News ; Digestive Disease Week, news release, May 19, 2008; U.S. National Institute of Diabetes and Digestive and Kidney Diseases (www.digestive.niddk.nih.gov)
Author: Anne Thompson
Publication Date: May 31, 2009
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