Got a question here and I'm hoping someone has some answers or experience that can help. I've heard that the bowel damage caused by Celiac disease can heal itself given enough time. How long does it take being gluten-free is typical to repair the damage? I've heard up to six months, but I suspect it could be longer.
Another issue here is lactose-intolerance. If you remain gluten-free, is it necessary to remain simply lactose free (using lactose-free products) or do you have to go completely milk-free? I'm not even 100% certain what the right terminology to use here is! Any help anyone can offer would be appreciated! Thanks in advance!
Does anyone know how long it usually takes for the bowel to heal after going totally gluten Free? Also do you have to go dairy free for the bowel to heal?
I have found lots of great info on Celiac but nothing telling me the average length of time the bowel takes to heal.
Time to healing is highly individual. Recent studies have found that younger celiacs (under 30 yrs. of age) tend to have significant improvement in their intestinal villi structure within 6 mos. However, older celiacs can take years to heal. In my gluten intolerance support group, we have a woman who took about seven years to heal. She started the diet in her 60s.
There are a couple of reasons why it can take longer than average to heal, even for young celiacs. First, it depends on how long the damage has been going on for. About one third of the population carries the major genes for celiac, however, current thinking is, it takes an environmental trigger to set off the damage. So, you can have two recently-diagnosed celiacs who are 20 yo, and they may heal differently because one may have been celiac since infancy, the other only since the past 8 mos. or so.
The second factor, and it is frequently overlooked, is other food intolerances that are perpetuating the autoimmune destruction. While gluten is what you most commonly hear about in relation to celiac disease, and it is primary there, the destruction to the gut allows other undigested proteins to enter the bloodstream. From there, the body may mount an allergic response, and/or it may develop an autoimmune response to the other protein. Nongluten autoimmune destruction can result from dairy, egg, or soy -- perhaps others, but these are most common. When a celiac is not healing despite faithful diet (this can be ckd w/antigliadin antibody load decreasing), it's reasonable to check for other causes.
NSAIDs are known to cause villi destruction in about 10% of chronic users. Various parasites can also destroy villi. There are other causes, more rare.
Studies suggest that up to 35% of recently diagnosed (by endoscopy) celiacs are lactose-intolerant. There is a test for lactose intolerance.
Whether or not dairy needs to be totally removed for a celiac is highly individual. In the majority of cases, no. However, if one has high levels of antibodies of any sort (IgA, IgG, IgE) to dairy, it certainly makes sense to remove it.
In nonceliac gluten sensitivity (much more common than celiac disease), sometimes results can be seen within a month of removing gluten from the diet, in adults. Even sooner with kids. But if anything, NCGS has a higher rate of other associated food intolerances.
Thank you for that great info. IT makes a lot of sense that the healing process would be individualized based on lengh of disease and severity of damage. I did want to ask what Non celiac gluten sensitivity is? How does this differ from celiac?
Nonceliac gluten sensitivity is a diagnostic entity that most regular MDs will not acknowledge. Its existence is disputed.
To understand what NCGS is, it helps to know that celiac disease is diagnosed on the basis of a panel of 4 blood tests plus endoscopic biopsy confirmation of damage to the villi of the small intestine. The gold standard for celiac diagnosis is a positive biopsy. It gets complicated because there are people with positive bloods & negative biopsies, and those with negative bloods & positive biopsies.
A person w/NCGS is someone who responds postively to GF diet, despite having either a negative blood panel and/or negative biopsy. (It may be difficult to get insurance to pay for endoscopy if labs are negative.). Some of these with NCGS have a simple IgE allergy to wheat and/or all gluten-bearing grains; however, that is not always the case.
There are thousands of people around the world who can attest to healing with GF diet. Of course, not everyone who tries the diet is helped by it, but many cases of longstanding, mysterious gut-grief, IBS, diarrhea, bloating, etc. are helped by GFD trial. The other group that shows benefit from GFD trial, smaller but growing, are those with neurological challenges: ataxia, autism, epilepsy.
Not everything about NCGS is understood, but usually leaky gut plays a role. Leaky gut is a commonality in gut & neuro disorders, because the gut mucosa & the blood-brain barrier arise from the same embryonic tissue & are predisposed to similar problems. While the whole concept of 'leaky gut' may bring a smile to your doctors' face, it has been confirmed by research, and in fact there are FDA trials currently underway for a drug to remediate leaky gut. Once there is a profitable drug, "leaky gut" will become a legitimate medical diagnosis.
Gluten is one of the most difficult protein molecules for the body to digest. The next most difficult is casein. So, if there is a glitch in digestion, gluten may not get broken down. Then, if there is a leaky gut (due to celiac, intestinal yeast/bad bacteria infiltration, gut measles, heavy metal damage, or whatever), the undigested gluten gets into the bloodstream & wreaks havoc. In people predisposed to autoimmune disease, celiac can develop. In others, the gluten just causes mischief & pain. If the BBB is compromised, the gluten can get into the brain & cause neurological symptoms.
The other factor that plays a role in NCGS is a "pre-celiac" phenomenon. A well-credentialled gastroenterologist in Dallas, Kenneth Fine MD, feels very strongly that celiacs don't just wake up one morning with their vili destroyed over night. It's a process that can take months or years. Dr. Fine has found that, in many symptomatic people with negative celiac panel & endoscopy, even though the autoimmune antibodies are not present in blood, they are being shed in the stool. Meaning, the gut is being affected. This is a grey area between normal & celiac, but if you think about it, it makes sense that destruction of an organ due to a chronic condition can sometimes occur over a period of time.
Sorry if this explanation seems muddled, as filtered through my own understanding. The bottom line is, that current clinical medicine tends to run very black/white, yes/no on issues of celiac disease & gluten sensitivity. Indeed, in the USA the medical community is decades behind Europe even in its understanding of clear-cut celiac disease. It was only in 2004 that the US National Institutes of Health announced that the incidence of celiac was not 1/5000 as previously thought, but closer to 1/100, similar to that of Europe. In Italy, for quite a while now, all kids are screened for celiac around 4 yo, and adults must have celiac blood testing done to get a marriage license.
The developing understanding of gut function, which hasn't yet filtered down to doctors' offices, is that 1) other factors than celiac disease may contribute to gluten intolerance, and 2) that even before vili are destroyed, people can be symptomatic. These things can predispose one to NCGS.
I have seen on the box of a probiotic supplement -- Primadophilus Reuteri--- by Nature's Way pictures of shortened villi before taking Reuteri and after with much longer villi. It also says clinically proven on the container..
Has anyone with Celiac tried this supplement to help heal damaged villi? And, if so how did it work?
I have used this probiotic supplement and it is one of the best that I have ever used.
The lactobacillus reuteri is also used in
Stonyfield Farm yogurt-- the only yogurt in North America that contains this patented culture strain. I also eat it daily because I like it.
I have used the Nature's Way Reuteri because it is so readily available. But, I really have not liked it because I have never got the repsonse with Nature's Way probiotic products that I have with others.
L. reuteri use to be distributed by Wal Mart in a better form about 5 years ago. It was a chewable slightly lemon flavored tablet. I think Wal Mart quit because it was dated and their supply system could not manage it before it went out of date.
That form is now distributed by Nature's Sunshine --online --a product of Sweden-- this is the only other L. reuteri product sold in the USA.
With gastrointestinal cramping and spasm -associated with a bacteria like e coli, salmonella or lysteria and others this product is the one that I could tell that it was working in 30 minutes or so. I have never taken a probiotic supplement with such rapid results!
The Nature's Way product has the pictures of the villi on the box.
The Nature's Sushine box says nothing about the villi-- it says " Helps Relieve Occasioal Gastrointestinal Distress and Helps Maintain Regularity and Suppresses the Growth of Unfiendly Bacteria".
Have you tried this product for damaged villi associated with Celiac?
We used the Nature's Way Primadophilus Reuteri, and only the powder form (not capsules or chewables). We purchased it at a healthfood store.
My DD would not be able to take the Nature's Sunshine product because of the corn protein it contains. (She developed severe multiple food intolerances as a result of the celiac/leaky gut.)
I doubt that any probiotic will reverse the autoimmune damage caused by celiac disease, in absence of dietary modification. If you don't get the undigested gluten out of the diet, down to the ppm level, destruction of the gut continues in celiac disease. Gluten triggers the body's own defense mechanisms to mount an attack against itself. In celiac disease, it's not just a matter of gut dysbiosis. Dysbiosis may co-exist, but it's not the main problem. At least as far as I understand things.
Beyond that, CD is nothing to fool around with. Without faithful GF diet, there is increased risk for other autoimmune diseases, and also for some very nasty gut cancers. So I have to be very firm in recommending that people w/CD remain on the GF diet, despite a suggestion of a supplement manufacturer that a probiotic is what will heal them.
Of course, if the supplement is GF, and someone wants to try it in addition to the diet, that may be where the benefit lies. Lots of celiacs do take probiotics to good benefit. And I've have heard many testimonials for L-glutamine speeding/ facilitating gut healing in celiacs on GFD, but am not sure that is backed up by research.
I'd love to see independent confirmation of the vili-lengthening stuff. Perhaps this result was in non-celiacs -- folks with vili damage from NSAID use, bacterial infection, or parasites.