Thin children? GF malabsorption in celiac/ gluten sensitivity

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Causes of fat malabsorption in celiac / gluten sensitivity,

and a breath test for lipase (fat digesting enzyme) levels:

Perri, Pastore, et al, 1998:

http://journals.lww.com/jpgn/Fulltext/1998/10000/Intraduodenal_Lipase_Activity_i\

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n_Celiac_Disease.8.aspx

Exocrine pancreatic insufficiency has been reported in patients with celiac

disease (CD) and may be so severe that it reduces the efficacy of the

gluten-free-diet (GFD) and requires pancreatic enzyme supplementation (1). The

most likely explanation for the impaired pancreatic function is a defective

meal-stimulated pancreatic lipase output, because gut damage severely affects

the intestinal release of secretin (2) and cholecystokinin (CCK) (3), which are

potent stimulants of pancreatic secretion. Pancreatic dysfunction in CD is

usually transient and reversible after repair of small bowel damage with a GFD

(4). However, recent studies have shown that low tryptic and lipolytic

intraduodenal activity also follows intravenous pancreatic stimulation with

secretin and CCK (4), implying that mechanisms other than intestinal mucosal

damage may account for the pancreatic insufficiency in CD.