<<Disclaimer: Verify this information before applying it to your situation.>>

   Thanks everyone,all 34 of you for responding to the gall-bladder post.  I
think this letter from Ron Hoggan will answer a lot of questions.  Thanks Don
for finding it for us.
   22 of 34 have had their gall-bladder removed, most several years before
being diagnosed with CD.
   One lady had her gall-bladder removed exactly one month after having a baby
and one lady had gall-stones exactly one month after having a baby.
   and one person has a cyst on the gall-bladder.
   Three teenagers had gall-bladder removed or stones before being diagnosed
with CD.
   If anyone wants to study these letters more I will forward them to you.

         Thanks


>      If you have gall-bladder problems or had gall-bladder surgery please
>send me a note and I'll compile the survey and post to the list.

From Ron's web site:

Written by: Ronald Hoggan <[log in to unmask]>

Gall bladder disease or malfunction is often associated with celiac
disease. It can cause pain in the upper right quadrant of the abdomen, just
at the lowest rib on the right side. In one study of 1300 celiacs in
Canada, 9% indicated that gall stones were the earliest presentation,
sometimes followed by many years prior to correct diagnosis of their celiac
disease. In another report, Dr. Kozlowska indicated that 13 of the 41 newly
diagnosed celiacs she investigated were suffering from atresia, a condition
which is a partial or complete blockage of the bile duct.

CCK (cholecystokinin) is the hormone responsible for gall bladder
contraction. The bulk of this hormone is produced in the duodenum.

Active celiac disease would be likely, then, to cause a reduction or a
cessation of duodenal production of CCK. A radiologist in Hungary is
currently researching this problem. In private correspondence, one
gastroenterologist reports having found (accidentally) a gallstone in a 12
year old girl who had active celiac disease.

The 30% incidence of atresia among celiac children, as reported by Dr.
Kozlowska, would suggest an even higher number among adults with active
celiac disease. Given the low level of clinical suspicion for celiac
disease in North America, it would not be at all surprising if a large
portion of patients with gall bladder disease were suffering from occult
celiac disease. Future research may reveal that gall stones and atresia are
only symptoms of celiac disease.

I did a Medline search on cck and celiac disease. I got 65 hits.
Researchers repeatedly identified a connection between celiac disease and
gall bladder malfunction with such comments as:
"Thus the already impaired fat absorption in celiac sprue is magnified by
the lack of bile delivery....."; and "We conclude that there is a
reversible defect of gallbladder emptying and cholecystokinin release in
celiac disease." and "Cholecystokinin (cck) release and gall bladder
emptying in response to a fatty meal are completely abolished in coeliac
disease." and "the abnormally decreased gallbladder contraction in coeliac
patients is the result of endogenous cck secretion and not a lack of
end-organ responsiveness to cck."

There just isn't much ambiguity there. If you've got celiac disease, you
have gall bladder malfunction, of the sort that may well develop into
atresia and gallstones.

Upon receiving a diagnosis of gall bladder disease, whether gall stones or
atresia, one might be wise to request a blood test for celiac disease. The
anti-endomysial antibody test is currently the most reliable and available
test.

Now, given the low level of clinical suspicion for celiac disease, I
anticipate the suggestion that absent gall bladder emptying, atresia, and
gall stones might occur in the absence of celiac disease. I did another
Medline search, and I can't find a single study that has tested atresia
patients or gallstone patients for celiac disease. My answer to the
suggestion that gall bladder disease may occur in the absence of celiac
disease is that there is no evidence to support such a contention.
Considerable evidence exists, however, which points to celiac disease as a
likely cause of gall bladder malfunction, atresia, or stones. As for
childhood gallstones, there appears to be only one answer.... it is
associated with celiac disease.

A view that incorporates the association of gall bladder disease, and
celiac disease, but does not preclude the above, has been expressed by Dr.
Joseph Murray, of the University of Iowa, who is a gastroenterologist
specializing in treating celiac disease. He believes there are several
"triggers" that can activate Celiac disease in genetically susceptible
people. One of them is: Surgery, particularly GI (gall bladder, etc.) In
any case, the connection between celiac disease and gall bladder disease is
well known.

More information is available at:

The Gluten-Free Page:  http://www.panix.com/~donwiss/

I hope this is helpful.

Ron Hoggan
http://www.panix.com/~donwiss/hoggan/