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Gluten
- Question
- Hello!
I read that CF patients often have difficulty to digest products with gluten. This information can be found in many sites, including this one:
http://www.naturosante.com/rubriques/conseils/conseil.php?24
I quote: "It was noted that children with CF are especially susceptible to products containing gluten."
Is this true? Do we know the reason? What are the consequences of gluten sensitivity? Are there studies on this?
If so, what precautions to observe concerning food?
Thank you.
- Answer
- Hello,
Gluten intolerance, or coeliac disease, is a common intestinal disease in the population. The ingestion of gluten, a protein contained in some cereals (as wheat, barley, rye, oats ...) causes damage to the intestinal wall, leading to malabsorption and digestive disorders. A gluten-free diet can restore a normal intestinal mucosa and resolve the symptoms.
In cystic fibrosis, the prevalence of coeliac disease seems higher than in the whole population. A recent study in Scandinavia including 790 patients with cystic fibrosis showed a prevalence three times higher. This study consisted in antibodies dosages (anti-transglutaminase and anti-endomysium), and intestinal biopsies in cases of positive antibodies. It allowed the diagnosis of some new cases.
Coeliac disease is underdiagnosed in patients with cystic fibrosis, because its symptoms are similar to those of pancreatic insufficiency in cystic fibrosis (abdominal pain, diarrhea, poor weight gain...).
If gastrointestinal symptoms persist despite optimal pancreatic enzyms treatment, the medical team may suggest gluten intolerance, and may propose explorations to confirm the diagnosis.
However, in the absence of confirmed diagnosis of coeliac disease, there is no dietary recommandations about gluten; it is useless and unsuitable to reduce gluten on its own initiative. A daily intake of cereals is necessary to ensure a hypercaloric diet, and a good growth.
Feel free to talk about this with your doctor or dietetician of the CRCM.
Best regards
Dr Michèle Gérardin
- 01.09.2011
