Wheat gliadin in rye and barley induces severe intestinal symptoms and small bowel damage in celiac disease patients. The most effective treatment to date for this autoimmune disorder is a strict gluten-free diet, a restrictive regimen. Wheat, rye and barley must be avoided as well as processed foods which use these ingredients as fillers or additives such as soups and taco spices.
There has been an explosion in gluten-free products in the marketplace, especially in the United States. Often adherents are using these products when no intolerance is actually present.
Probiotics appear to have a possible role in celiac disease. A recent review in Clinical Microbiology Reviews discusses the microbiota in celiac disease and the use of probiotics as a novel therapy. Microbiota profiles differ in children with the disease and those without. Those with celiac disease have fewer lactobacilli and bifidobacteria. Specific probiotics may digest or alter gluten polypeptides. Some bacterial species belonging to the genera lactobacillus and bifidobacterium exert protective properties on epithelial cells from damage caused by gliadin.
Microbiota may inhibit the toxic effects of gliaden in intestinal cells. They may do this by competing with harmful bacteria or yeast or by secreting chemicals that discourage them. Bifidobacterium lactis was recently found to effectively counteract some of the harmful effects of gliadin involving epithelial permeability and resistance as well as protecting the tight junctions of cells where gliadin does harm. The Finnish researchers who published this study in June 2008 said the positive results called for more research into this novel treatment for celiac disease. It is thought that probiotics such as Bifidobacterium lactis while not totally precluding the need for avoidance of a gluten-free diet, may be helpful in mucosal recovery or for patients who are not responding to a gluten-free diet or for protection when gluten is ingested unknowingly.
In addition, scientists found a link between children with celiac disease and delivery by cesarean section. Twenty eight percent of the celiac children were born by cesarean section compared to no more than 19 percent of the other groups. The theory is that newborns are exposed to their first microbes in the birth canal and when they take a different route, the intestinal mix of microbes changes. Rates of C-sections have almost doubled in the last decade, especially in affluent countries. One in three mothers in the United States now gives birth this way. Other celiac disease researchers found the results intriguing but cautioned jumping to conclusions, especially because cesarean sections, though possibly overused, have an important role in safe childbirth.