[Celiac disease : Pathogenesis, clinics, epidemiology, diagnostics, therapy]

Trends in the Use of Plant Non-Starch Polysaccharides within Food, Dietary Supplements, and Pharmaceuticals: Beneficial Effects on Regulation and Wellbeing of the Intestinal Tract

As the demand for healthy products targeted to prevent or ameliorate bowel disease and digestive disorders of the intestinal tract is increasing, this review describes non-starch polysaccharides, such as β-glucan, arabinoxylan, galactomannan, fructan, and heteropolysaccarides from mucilages, as useful sources for adequate and tailor-made products aimed for regulation of the colon and wellbeing effects on the gut microbiota. Their monosaccharide composition, structure, molecular dimensions, physicochemical characteristics and growth stimulation of lactobacilli and bifidobacteria in the gut microbiota is reported. Arabinoxylan from wheat and rye grains is discussed as an ingredient for gluten and lectin-free bread and baked goods. Galactomannans from legumes and their partially hydrolysed products are presented as sources for specific healthy products against bowel disease and digestive discomfort. Commercial fructan products obtained from inulin, fructan of agave, and fructooligosaccharides are discussed in detail as a selective substrate for fermentation by health-promoting bacteria in the colon, such as lactobacilli and bifidobacteria. Structurally different heteropolysaccharides from mucilages of traditional medicinal plants, such as seeds from psyllium, flax, chan, chia, and basil or cladodes from Opuntia spp., are discussed as useful sources of dietary fibre, with prebiotic characteristics and digestive regulation in the intestinal tract as well.

[Celiac disease in adult patients revealed by polyserositis: about a case]

Celiac disease (CD) is an autoimmune disease affecting multiple organs. It often presents as gastrointestinal manifestations associated with malabsorption. However, serosa involvement uncommonly reveals this enteropathy, making the diagnosis difficult. We here report the case of JA, aged 63 years, admitted to hospital to detect the cause of malabsorption syndrome associated with polyserositis signs including pleurisy, pericarditis, ascites and hydrocephalus. The diagnosis of CD was based on endoscopic signs without serology tests. Patient's evolution was partially favorable, due to lack of compliance with a gluten-free diet. Our study reports the first case of CD revealed by polyserositis. CD should be suspected in patients with malabsorption syndrome, in the absence of evocative signs.