Dangerously Overlooked Cause of Crohn’s Disease

Crohn’s disease is a lifelong struggle for many people. It could be a life sentence of pain and suffering. Besides prescription medicines, the answer may come in the form of a highly effective dietary solution plus inexpensive vitamin supplement.

1. What is the right diet for patients with Crohn’s Disease?

A gluten-free diet is recommended for people who suffer from the bowel affliction called celiac disease. While symptoms of celiac and Crohn’s disease may be similar, there may be a deeper connection to these two afflictions.

2. The Crohn’s/Celiac Connection.

A study from a few years back found that people with Crohn’s disease are also frequently inflicted with celiac disease. Armed with this breakthrough finding, the study’s authors recommend that those who suffer from Crohn’s disease should follow a gluten-free diet as well.(2)

The study confirms what I already know from personal experience: a gluten-free diet not only works well for people with celiac disease, but also for patients with ulcerative colitis and Crohn’s disease.

3. B-complex Vitamins Benefits.

If you’re going to follow a gluten-free diet, there’s a more recent study that you need to know about. It states that B vitamin supplementation is a must if you are eliminating gluten from your diet. That will help keep your energy levels high and promote overall well-being.

Scientists from Coeliac Centre at the Norrkoping Hospital in Sweden conducted a study on 65 coeliac patients. They were divided into two groups. The results of the study proved that patients taking folic acid, B12, and B6, experienced less anxiety and enjoyed overall well-being and better mood as compared to the group taking the placebo.(1)

The gluten-free diet is, you guessed it, completely free of ingredients that contain gluten, including wheat, barley, rye, and triticale (a hybrid of wheat and rye), as well as gluten found in food additives.

The gluten-free diet has grown in popularity in recent years. According to Cynthia Kupper, executive director of the non-profit Gluten Intolerance Group of North America, marketers estimate that 15 to 25 percent of consumers want gluten-free foods. However, doctors estimate that only one percent of those people have celiac disease.

4. Can I Dine Out Following a Gluten-Free Diet?

Yes. As restrictive and difficult as it may sound to avoid gluten and lead a normal lifestyle, you can check out www.glutenfreetravelsite.com which can help you find restaurants that offer gluten-free items on their menu.

Studies:

1. Clinical trial: B vitamins improve health in patients with coeliac disease living on a gluten-free diet.
Hallert C, Svensson M, Tholstrup J, Hultberg B.

Coeliac Centre, Norrköping Hospital, Norrköping, Sweden. Claes.Hallert@lio.se

BACKGROUND: Patients with coeliac disease living on a gluten-free diet show vitamin deficiency and reduced subjective health status. AIM: To study the biochemical and clinical effects of B vitamin supplementation in adults with longstanding coeliac disease.

METHODS: In a double blind placebo controlled multicentre trial, 65 coeliac patients (61% women) aged 45-64 years on a strict gluten-free diet for several years were randomized to a daily dose of 0.8 mg folic acid,0.5 mg cyanocobalamin and 3 mg pyridoxine or placebo for 6 months. The outcome measures were psychological general well-being (PGWB) and the plasma total homocysteine (tHcy) level, marker of B vitamin status.

RESULTS: Fifty-seven patients (88%) completed the trial. The tHcy level was baseline median 11.7 micromol/L (7.4-23.0), significantly higher than in matched population controls [10.2 micromol/L (6.7-22.6) (P < 0.01)]. Following vitamin supplementation, tHcy dropped a median of 34% (P < 0.001), accompanied by significant improvement in well-being (P < 0.01), notably Anxiety (P < 0.05) and Depressed Mood (P < 0.05) for patients with poor well-being.

CONCLUSIONS: Adults with longstanding coeliac disease taking extra B vitamins for 6 months showed normalized tHcy and significant improvement in general well-being, suggesting that B vitamins should be considered in people advised to follow a gluten-free diet.

2. High prevalence of celiac disease among patients affected by Crohn’s disease.

Tursi A, Giorgetti GM, Brandimarte G, Elisei W.

Digestive Endoscopy Unit, “Lorenzo Bonomo” Hospital, Andria, Italy. antotursi@tiscali.it

BACKGROUND: Recent literature has shown a correlation between Crohn’s disease (CD) and celiac disease, but a prospective study has not been performed. Our aim was to evaluate the prevalence of celiac disease in a consecutive series of patients affected by CD, in whom the disease was diagnosed for the first time.

METHODS: From January to December 2004, we diagnosed 27 patients affected by CD (13 men and 14 women; mean age, 32.3 yrs; range, 16-69 yrs). In all patients, we performed antigliadin, antiendomysium, and antitransglutaminase antibody tests, and the sorbitol H2 breath test evaluation. In case of antibodies and/or sorbitol positivity, esophagogastroduodenoscopy was performed for a small bowel biopsy.

RESULTS: Antigliadin, antiendomysium, and antitransglutaminase antibody tests were positive in 8/27 (29.63%), 4/27 (14.81%), and 5/27 (18.52%) patients, respectively, whereas the sorbitol H2 breath test was positive in 11/27 (40.74%) patients: all of them underwent esophagogastroduodenoscopy. Nine of 11 patients showed signs of duodenal endoscopic damage, and 5/9 (55.55%) showed histologic features of celiac disease (18.52% of overall CD population studied): 2 showed Marsh IIIc lesions (1 patient affected by ileal CD and 1 affected by ileo-colonic CD), 2 showed Marsh IIIb lesions (all of them affected by ileo-colonic CD), 1 showed a Marsh IIIa lesion (1 patient affected by colonic CD).

CONCLUSIONS: Prevalence of celiac disease seems to be high among patients affected by CD, and this finding should be kept in mind at the time of the first diagnosis of CD; a gluten-free diet should be promptly started.