The gluten-free diet prescribed
for the digestive disorder celiac disease may reverse liver failure in
some patients with both conditions.
And, the relatively high frequency
of undiagnosed celiac disease among people with serious liver conditions
suggests the disorder should be looked for in certain liver disease patients.
Celiac disease is a digestive
disorder that damages the small intestine and interferes with the normal
absorption of nutrients from food. It arises from an allergic reaction
to gluten, a protein found in wheat, rye, barley, oats and spelt.
The problem often goes undetected
because many of its symptoms -- such as abdominal pain, fatigue and diarrhea
-- are similar to a range of other disorders. And some patients have no
Celiac disease is also associated
with other disorders caused by immune system dysfunction, including immune
system-related liver diseases like autoimmune hepatitis.
In their study of 185 patients
who had received liver transplants, researchers found that eight patients
-- or just over 4% -- had celiac disease. Two of these eight had not been
diagnosed previously, and in five patients, the liver disorder had developed
when their celiac disease was still undiagnosed. Only one had stuck to
a long-term gluten-free diet before the liver transplant.
Moreover, in another
four patients with advanced liver disease and untreated celiac disease,
the investigators found that a gluten-free diet reversed patients' liver
The two who have adhered to
the diet remain in good condition, the researchers report. One patient
who did not stick with the diet saw his liver disease progress and eventually
had a liver transplant.
These findings suggest that
in such patients, dietary intervention may prevent progression to liver
And, they point out, their
finding that about 4% of liver transplant patients had celiac disease
-- usually associated with autoimmune liver disorders -- indicates that
celiac disease should be "rigorously investigated" in all patients
with autoimmune hepatitis or hepatitis with no known cause.
In some cases, early detection
and treatment of celiac disease may prevent progression to end-stage liver