The following is a patient case history from the clinic of Alexander R. Shikhman, MD, PhD, FACR :
A 28 year old woman was seen in our clinic due to her complaints of longstanding irritable bowel syndrome and recent onset of eye dryness. Her initial presentation included abdominal pain, bloating and irregular bowel movements. She was seen by several gastroenterologists and underwent several upper endoscopies and colonoscopies with mucosal biopsies which were non-diagnostic. Her lab test results showed positive IgG antigliadin antibodies and she was told that "this is a common finding among healthy people, and is not indicative of any illnesses." She was seen by her ophthalmologist and prescribed with contact lenses which she could not wear due to significant eye discomfort and irritation. Further eye examination showed that she had diminished tear production and was referred to our clinic to rule out Sjogren's syndrome.
Upon physical examination in our clinic the patient not only demonstrated profound eye dryness but also showed evidence of dry mouth, fissured tongue and patchy areas ofthrush as well as very dry skin. A sonographic evaluation of her major salivary glands was suspicious for moderately advanced Sjogren's syndrome. Her laboratory test results showed: positive anti-SSAI Ro antibodies, elevated serum immunoglobulin G, low neutrophil count as well as low levels of vitamin D and fenitin (a serum marker of iron storage state). Also, the patient was found to have positive serum IgG and salivary IgA anti-gliadin antibodies as well as positive HLA 002 (a molecular marker associated with gluten intolerance).
Based on a combination of clinical history, physical findings and laboratory test results, the patient was diagnosed with gluten intolerance and Sjogren's syndrome. In addition to the aforementioned tests, the patient underwent food intolerance testing based on serum IgG4 antibodies which showed not only gluten but also cow's casein intolerance. Her treatment options included a traditional route of therapy based on drugs or an integrative approach based on dietary modifications and food supplements. She opted for the integrative approach and started a gluten-free and dairy-free diet as well as iron glycinate, vitamin D, specific probiotics and digestive enzymes.
After the first month on the diet and supplements, she reported a remarkable improvement of her irritable bowel symptoms and in three months, she started noticing an improvement of the dryness. Laboratory tests performed six months after initiation of the therapy showed normalization of the IgG level, disappearance of anti-SSA/Ro antibodies and a slightly suppressed neutrophil count. Through following the prescribed diet and supplements she is now symptom free.
Melissa at gluten free for good has great recipes and wisdom if you are following this dietary path.
Melissa says "The gluten-free diet is the medical protocol for celiac disease. Why not for all autoimmune diseases? Gluten causes inflammation. Decreasing inflammation via diet and lifestyle should be the first step in reducing the impact of the disease, so it makes sense to eliminate gluten.
Apparently Venus is on a vegan diet to combat her symptoms. There are rumors she’s dabbling in the gluten-free diet as well."
Melissa is author of The Gluten-Free Edge
one-pot roasted salmon, rice and vegetables
What do you think? Should people with autoimmune conditions follow a gluten-free diet?
Have you tried a gluten free diet to help your Sjögren’s Syndrome?