In this video Dr. Vikki Petersen discusses a study published in BMC Gastroenterology in February of 2013, while providing her thoughts based on her own professional experience treating patients with celiac disease. The study, which involved celiac disease expert Dr. Alessio Fasano, looked at patients who had non-responsive celiac disease — meaning they weren’t responding to a gluten-free diet. The title of the article is “Trace gluten contamination may play a role in mucosal and clinical recovery in a subgroup of diet-adherent non-responsive celiac disease patients”. To read about the study as published in BMC click here.
The study looked at patients who had persistent symptoms (in some cases continuing villous atrophy) even though they were adhering to a gluten-free diet. These patients were labeled as having non-responsive celiac disease (NRCD) and some of them were thought to have refractory celiac disease. Researchers wanted to see if any of these patients were reacting to gluten cross contamination so they put study participants on a specific Gluten Contamination Elimination Diet to see if their symptoms would improve.
The study specifically looked at 17 patients who finished the set diet, 6 of which met the criteria for refractory celiac disease prior to the study. The Gluten Contamination Elimination Diet, created by the researchers themselves, was followed by these patients for 3 to 6 months. The diet consisted of whole, unprocessed foods that have an extremely low (or no) probability of being contaminated by gluten. Foods on this diet included white or brown rice, fresh whole foods, herbs, oils, salt and honey; dairy was allowed eventually, but it was excluded for the first month. For more details on this prescription diet and some advice on how to best implement it, read my guide: Gluten Contamination Elimination Diet.
Of the 6 patients who met the criteria for refractory celiac disease 5 of them were asymptomatic after following the diet and they no longer met the criteria for refractory celiac disease. Overall 14 of the 17 patients responded positively to the diet and 11 of them were able to return to a traditional gluten-free diet without a reappearance of the symptoms they previously had.
These findings are important because the diagnosis of refractory celiac disease is very serious as is the treatment for it — immunotherapy. Immunotherapy medications prevent the immune system from attacking the intestine, but they also prevent the immune system from protecting the body from the other things it is designed to protect the body from like bacteria and infectious diseases. Effective refractory celiac disease treatment should begin with the Gluten Contamination Elimination Diet in hopes that immunotherapy medications can be avoided.
As she mentions in the video this is a great study to share with any friends or family members who have been diagnosed with refractory celiac disease or who just aren’t getting better on a standard gluten-free diet.