Background: Among people who are genetically predisposed to celiac disease (CD), eating GLUTEN, which is part of the structure of many grains, can lead to intestinal tract damage with an inadequate immune response. The purpose of the present study was to investigate the frequency of gallstones in CD. Materials and Methods: In this analytical cross-sectional study, all CD data were analyzed using the West Azerbaijan Population-Based Celiac Registry (WA-PBCR) database. The mainly evaluated criterion in this study was the frequency of gallstone in samples with CD. For evaluating the results, information related to gender, age, body mass index (BMI), bilirubin, and cholesterol level, anti-transglutaminase antibody level, and the frequency of gallstones were extracted from CD files. Results: Overall, 260 patients with CD were included in the study. The median age of the patients with CD was 33 years, and 66. 5% and 33. 5% of the patients were females and males, respectively. Gallstones were detected in 11 CD-diagnosed cases (4. 23%). There was no significant relationship between the frequency of gallstones and age (P = 0. 193), gender (1. 00), and obesity based on the BMI (P = 0. 684) in patients with CD. Finally, 3 (1. 15%) of the referred patients with the recognition of gallstones were diagnosed with CD. Conclusion: The prevalence of biliary stones in celiac patients may be higher compared to the normal population. Hypocholesteremia is the predisposing factor for gallstones. In general, a significant relationship was found between the frequency of gallstones and bilirubin levels in patients with CD.

Celiac disease (CeD) is a widespread autoimmune enteropathy caused by DIETary GLUTEN peptides in genetically susceptible individuals, which includes a range of intestinal and extraintestinal manifestations. Currently, there is no effective treatment for CeD other than strict adherence to a GLUTEN-FREE DIET (GFD). However, persistent or frequent symptoms and also partial villus atrophy were observed in some patients with CeD due to intentional or inadvertent GLUTEN exposure during the use of GFD. It means that GFD alone is not enough to control CeD symptoms and long-term complications. Accordingly, new therapeutic approaches for CeD treatment such as GLUTEN proteolysis, removing GLUTEN from the digestive tract, promoting tight junction assembly, inhibiting intestinal tissue transglutaminase 2, using probiotics, and developing immunotherapeutic methods have been proposed through different strategies. This review focused on discussing the novel therapeutic strategies for CeD management.

Aim: Herein, we present five children and adolescents with a final diagnosis of non-celiac GLUTEN sensitivity (NCGS). Background: Non-celiac GLUTEN sensitivity (NCGS) is a condition characterized by gastrointestinal and extra-intestinal symptoms triggered by ingestion of GLUTEN-containing compounds, e. g., wheat, rye, and barley, in subjects without celiac disease or wheat allergy. Methods: Demographic characteristics, clinical manifestations, serum biomarkers and skin prick test were evaluated. Patient data was also recorded after they followed a GLUTEN-FREE DIET (GFD). Height and weight were measured, and all patients were examined 6 months after following the suggested GFD. Results: All patients had failure to thrive and abdominal pain. Clinical symptoms were reduced, and significant weight and height gains were detected after 1 month of following a GLUTEN-FREE DIET. Conclusion: The relationship between failure to thrive (FTT) and NCGS is still unknown; hence, NCGS may be one of the main causes of FTT which can be prevented by GLUTEN-FREE DIETs.

Background Celiac disease (CD) is a systemic autoimmune disorder due to immune response triggered by ingestion of GLUTEN in the DIET. Treatment with lifelong GLUTEN-FREE DIET may impact negatively on the health-related quality of life and may lead to psychological disturbances. The purpose of study was to evaluate quality of life, depression and anxiety in children with celiac disease. Materials and Methods In this cross-sectional study was done between 2013 and 2014 at the Gastroenterology Outpatient Clinic (Ghaem Hospital, Mashhad-Iran), patients with serology and biopsy-proven CD, on a GLUTENFREE DIET for at least one year, were included in this study and compared with non-celiac healthy children as controls. We used the questionnaire to investigate quality of life, anxiety and depression. Results There were statistically significant differences between the mean total anxiety (state, trait) scores and depression score in the celiac patients and control group. Correlations between state and trait anxiety and depression were statistically significant (P= 0. 01, r= 0. 35) and (P= 0. 001, r= 0. 52). Reverse correlations between quality of life of CD children and anxiety (state, trait) were statistically significant (P= 0. 001, r= 0. 51 and P= 0. 02, r= 0. 32). Mean total score of quality of life was not different in the two groups, but in the physical activity component, quality of life was better in CD patients (P=0. 008). Conclusion In current study, anxiety and depression had a significant impact on the course of celiac disease.

Celiac disease (CD) is an autoimmune disorder of the small intestinal mucosa in genetically susceptible subjects consuming GLUTEN. GLUTEN in wheat, rye and barley is harmful for some individuals and leads to various symptoms. Research has shown that treatment with probiotics in CD patients could improve the symptoms by the GLUTEN hydrolysis. For this purpose, different databases such as Medline, PubMed, Scopus, and Google Scholar were searched using the following keywords: Celiac disease, Wheat flour, GLUTEN, glutamine, Probiotic, Bifidobacterium, Lactobacillus, Enzymes, Wheat allergy, Immune system, T cells, HLA-DQ2, HLA-DQ8, GLUTEN-FREE DIET, Proteolysis, α 2-gliadin fragment, Gliadin, 33-mer peptide, and Zonulin. The search aimed to retrieve the articles published during 2000-2019. Today, a GLUTEN-FREE DIET (GFD) is the only celiac disease treatment. Biotechnological strategy based on probiotic treatment could degrade GLUTEN. Research has shown that combination of the probiotic enzyme is more effective than single probiotic on GLUTEN hydrolysis. The result of different studies showed that probiotic mixture has the capacity to hydrolyze a considerable concentration of the 33-mer of gliadin completely. The present study was aimed to investigate associations between the capacities of probiotics on GLUTEN hydrolysis.

Aim: This pilot study assessed the benefits of an adjuvant low FODMAP DIET (LFD) in adult CD patients established on GFD who had a normal remission biopsy. Background: Patients with biopsy-proven adult celiac disease (CD) may have on-going gastrointestinal symptoms despite adherence to a GLUTEN-FREE DIET (GFD). Functional gut symptoms, including irritable bowel syndrome (IBS), is one cause of persistent symptoms in CD patients. Methods: Twenty-five adult CD patients who were adherent to the GFD were recruited. These patients had histologically normal villi on their remission biopsy. A specialist DIETitian then offered an adjuvant LFD. Symptom response was assessed using the Gastrointestinal Symptom Rating Scale (GSRS) from baseline to follow up. Results: Of the 25 CD patients in remission with concurrent IBS, 9 did not wish to pursue the LFD, and 1 had incomplete data. Fifteen patients completed a minimum of four weeks on the LFD (mean age 44 ± 17. 3; range 43. 2 years; median duration of CD follow-up 7. 2 years). Global relief of gut symptoms was reported by 8/15 patients (53% p = 0. 007). Significant reductions in abdominal pain (p <0. 01), distension (p < 0. 02), and flatulence (p <0. 01) were demonstrated. Conclusion: This is the first study to demonstrate that an adjunct LFD is an effective DIETary treatment for concurrent IBS in adult CD patients with biopsy-confirmed remission. Such patients should be seen by a specialist DIETitian to ensure nutritional adequacy and appropriate reintroduction of FODMAP-containing foods.