<<Disclaimer: Verify this information before applying it to your situation.>> Hi all - The following excerpt is forwarded with the permission of Judy Malinowski, who runs the online CCClub Newsletter: CCClub Newsletter #108 17 Dec. 1998 [log in to unmask] ********************************************************** Report from Dr. Fine on the relationship of microscopic colitis to celiac sprue About 2000 years ago a famous physician named Aretaeus living in a country called Cappadocia (now in present-day Turkey) made some strikingly accurate observations. As documented in his translated writings, he noticed there were pale emaciated individuals that for no obvious reason experienced heavy pains of the stomach, and diarrhea, consisting of undigested food in a fluid state. Aretaeus called this syndrome "The Coeliac Affection." Today we know it similarly as celiac disease or celiac sprue. Although not known 2000 years ago, we now know that the small intestinal disease, celiac sprue, is caused by a dietary protein called gluten derived from wheat, barley, rye, and oats. If this disorder is not recognized and properly treated, patients experience chronic diarrhea, weight loss, bone mineral loss, malnutrition, anemia from vitamin/iron deficiencies, and muscle emaciation. It is treated by a rigorous diet that eliminates the grains containing gluten from the diet. In a research study conducted and reported last year, we discovered that microscopic colitis was responsible for most cases of chronic diarrhea after patients with celiac sprue were diagnosed and treated (published in the journal Gastroenterology June1997, volume 112, pages 1830-1838). This year we have discovered why this is so. It turns out that the same gene that predisposes to celiac sprue also predisposes to the development of the microscopic colitis syndrome (both the collagenous and lymphocytic types). This means that patients with sprue can get microscopic colitis (which we already knew) but also that patients with microscopic colitis can get celiac sprue. However, the gluten sensitivity in colitis patients may not display classic features but instead may be so mild that it cannot even be diagnosed by current methods. We are working on a more "molecular" method to diagnose occult gluten sensitivity. It is my opinion that everyone with microscopic colitis should have the blood tests looking for celiac sprue/gluten sensitivity, especially if your colitis has been difficult to treat or if you have had early relapses after successful treatment with Pepto Bismol or another agent. There are three blood tests: Antigliadin antibodies of two types: IgG and IgA, and antiendomysial antibody (IgA). I will relate more details as they develop. Our next treatment study (hopefully to be started in 1-2 months) has had built into the protocol tests to insure that patients with microscopic colitis do not have celiac sprue also. Thank you for your interest. Kenneth Fine, M.D. ************************************************************ FYI: Dr. Fine is at Baylor in Texas. <snip>