Gluten enteropathy

Vitamin 8 2 deficiency Vitamin B-12 deficiency due to malabsorption syndrome as seen in pernicious anemia Gl pathology, dysfunction or surgery fish tapeworm infestation malignancy of pancreas or bowel gluten enteropathy sprue small bowel bacterial overgrowth total or partial gastrectomy accompanying folic acid deficiency. Increased vitamin B-12 requirements Increased vitamin B-12 requirements associated... 

Of significant interest is an attempt to nse Enterosgel for therapy of chronic hard-to-treat diseases of gastro-intestinal tract snch as malabsorption syndrome, gluten enteropathy, exacerbation of chronic enteritis, post-resection syndrome and the syndrome of irritated large bowel. 

Informed consent and experimental procedures were consistent with the Declaration of Helsinki All volunteers were in good health except an elderly subject who was studied because he had gluten enteropathy All volunteers living in the metabolic unit were fed constant mixed diets prepared from conventional foods All subjects were chaperoned when they left the metabolic unit to prevent ingestion of unauthorized foods or loss of excreta samples ... 

Gluten-sensitive enteropahy A subject with gluten enteropathy was tested While tiospitalized with this disease he had been found to have a plasma Zn of < 5 yg/dl (1S)> It was desired to determine if he had abnormal Zn absorption or was Zn-deficient due to the diarrhea and malnutrition of his disease We found that he had normal absorption of Zn Fe and Cu from Trutol (Table IV) while on a gluten-free diet. 

Celiac disease, now called sprue or gluten enteropathy, is probably due to a genetic flaw that entails immune system dysfunction. The people who get this disease have bowel reactions to the chemical gliaden in the gluten of wheat, barley, rye, and oats, with inflammation and mild-to-severe damage to the small intestinal wall. Symptoms include irritability, abdominal distress and distention, vomiting, diarrhea, terrible gas problems, and weight loss. 

Cholesterol and fat-soluble vitamins require bile acid induced micellar solubilization for absorption, which takes place in the upper small intestine (c/. 32,116-118). Accordingly, in bile salt deficiency states, cholesterol absorption should be markedly impaired and fecal neutral sterol excretion increased. The fact that fecal neutral steroid excretion on a low-cholesterol diet is actually normal, as after ileal resection, ileal bypass, and cholestyramine treatment, or even decreased, as in cirrhosis of the liver or biliary occlusion (11), is due to a markedly reduced biliary secretion of cholesterol. In gluten enteropathy, in which no excessive bile salt loss usually exists, fecal neutral sterol excretion is markedly augmented (119). However, in occasional cases in which fecal bile salt elimination is markedly enhanced, the fecal neutral steroid excretion is quite normal, probably owing to decreased biliary cholesterol secretion as a consequence of low biliary bile salt secretion. Detailed information on the role of bile salts in both intraluminal and mucosal phases of fat and sterol absorption is presented in many recent reviews (6,10,113,114,117). 

Effects in Patients with Gluten-induced Enteropathy. 83... 

The change in daily output of fecal fat forms the basis for the definitive diagnostic test for gluten induced enteropathy (F16, F21). This diagnosis is justified if the patient presented with the main features of the malabsorption syndrome, if the fecal fat output fell to normal levels on a gluten-free diet, and if subsequent reintroduction of gluten into the diet caused an unequivocal increase in fecal fat... 

The main points of differentiation are summarized in Table 2. It will be seen that the group can be divided up into gluten-induced enteropathy, acute sprue, chronic sprue and idiopathic steatorrhea. As the cause of the sudden development of severe folic add deficiency... 

Gluten-induced enteropathy Acute sprue Chronic sprue Idiopathic steatorrhea... 

Two types of patient will be considered first, those that are suffering from gluten-induced enteropathy as already defined second, those that do not conform to the criteria required for the diagnosis of gluten-induced enteropathy, but are gluten-intolerant in that they show some improvement on a gluten-free diet. 

Fractionation of Wheat Gluten Complete acid hydrolysis of the gluten results in loss of its deleterious properties. Deamidation by acid or by treatment with papain (K6) also markedly reduces its toxic action on patients with gluten-induced enteropathy. However, peptic/tryptic digestion does not significantly reduce toxicity (F27). This might be expected from the fact that... 

Fig. 1. Some fractions of wheat gluten used for the study of the deleterious action in gluten-induced enteropathy.

The Effects of Wheat Gluten and Wheat Gluten Fractions on Patients with Gluten-Induced Enteropathy and Isolated... 

Steatorrhea in patients with gluten-induced enteropathy + + + — — 0... 

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