Use of basis images for detection and classification of celiac disease.

Celiac disease commonly occurs in approximately 1% of populations, but it can be difficult to diagnose. The standard method to diagnose celiac disease includes analysis of endoscopy images of the small intestinal mucosa to detect presence of villous atrophy, which can be subtle. We have devised a means to improve the image-based detection of villous atrophy and other abnormality in videocapsule endoscopy by means of incorporating basis images.

Methods to quantitate videocapsule endoscopy images in celiac disease.

In this work, bioengineering methods that can be used to quantitatively analyze videocapsule endoscopy images that have been acquired from celiac patients versus controls are described. For videocapsule endoscopic analysis, each patient swallows a capsule which contains an imaging device and light source. In celiac and control patients, images are acquired and analyzed at the level of the small intestine.

Dietary Supplement Use in Patients With Celiac Disease in the United States.

Background: There has been increasing interest in the use of complementary and alternative medicine (CAM) in the general population. Little is known about CAM use in patients with celiac disease (CD).

Goals: We aimed to determine the demographics and clinical characteristics of patients with biopsy-proven CD who use dietary supplements to treat their symptoms.

Characteristics of patients who avoid wheat and/or gluten in the absence of Celiac disease.

Background: Gastrointestinal symptoms that respond to the removal of wheat and/or gluten are becoming more common. Patients who avoid wheat and/or gluten (PWAWG) are a heterogeneous group and predominantly self-diagnosed prior to presenting for clinical evaluation.

Specific Aim: We characterized PWAWGs seen at a tertiary care referral center and compared them to patients with celiac disease (CD) and subjects in the National Health and Nutrition examination survey (NHANES).

Interest in medical therapy for celiac disease.

Objectives: A gluten-free diet is the treatment for celiac disease, but pharmaceutical agents are being developed. The level of interest amongst patients in using a medication to treat celiac disease is unknown. This study examined the level of interest amongst patients in medication to treat celiac disease.

Implementation of a polling protocol for predicting celiac disease in videocapsule analysis.

Aim: To investigate the presence of small intestinal villous atrophy in celiac disease patients from quantitative analysis of videocapsule image sequences.

Methods: Nine celiac patient data with biopsy-proven villous atrophy and seven control patient data lacking villous atrophy were used for analysis. Celiacs had biopsy-proven disease with scores of Marsh II-IIIC except in the case of one hemophiliac patient.

Prevalence of gluten-free diet adherence among individuals without celiac disease in the USA: results from the Continuous National Health and Nutrition Examination Survey 2009-2010.

Objectives: Clinical inference suggests the prevalence of non-celiac gluten sensitivity is substantially higher than that of celiac disease in the USA. Unfortunately, there are currently no data supporting these claims. The authors analyzed nationally representative data to estimate the prevalence of adherence to a gluten-free diet among participants without celiac disease and also to characterize the demographics and general health status of these participants.

Use of shape-from-shading to estimate three-dimensional architecture in the small intestinal lumen of celiac and control patients.

Background: As measured from videocapsule endoscopy images, the small intestinal mucosa of untreated celiac patients has significantly greater and more varied texture compared to normal patients. Three-dimensional modeling using shape-from-shading principles may further increase classification accuracy.

Methods: A sequence of 200 consecutive videocapsule images acquired at a 2s(-1) frame rate and 576×576 pixel dimension, were obtained at four locations in the small intestinal lumen of ten patients with biopsy-proven celiac disease and ten control patients.

Is dietitian use associated with celiac disease outcomes?

A gluten-free diet (GFD) is the treatment for celiac disease (CD), but due to its complexity, dietitian referral is uniformly recommended. We surveyed patients with CD to determine if dietitian use is associated with quality of life, symptom severity, or GFD adherence. The survey utilized three validated CD-specific instruments: the CD quality of life (CD-QOL), CD symptom index (CSI) and CD adherence test (CDAT).

Villous atrophy and negative celiac serology: a diagnostic and therapeutic dilemma.

Objectives: Patients with villous atrophy (VA) and negative celiac disease (CD) serologies pose a diagnostic and therapeutic dilemma. When a definitive etiology for VA is not determined, patients are characterized as having unclassified sprue (US), the optimal management of which is unknown.

Methods: We studied adult patients with VA on biopsy and negative celiac serologies, evaluated at our tertiary referral center over a 10-year period.

Prevalence of migraine in patients with celiac disease and inflammatory bowel disease.

Objective: To assess the prevalence of headache in clinic and support group patients with celiac disease and inflammatory bowel disease (IBD) compared with a sample of healthy controls.

Background: European studies have demonstrated increased prevalence of headache of patients with celiac disease compared with controls.

Methods: Subjects took a self-administered survey containing clinical, demographic, and dietary data, as well as questions about headache type and frequency.

Video capsule endoscopy in celiac disease.

Video capsule endoscopy (VCE) provides a safe, non-invasive way to visualize the small intestine and is helpful in celiac disease patients in select situations. VCE can be performed in patients who are unable or unwilling to undergo conventional endoscopy, those with positive celiac serology with normal duodenal biopsies, and also in those who develop alarm symptoms. VCE has limitations including subjective interpretation.

Small bowel imaging in celiac disease.

Celiac disease is a common inflammatory disease of the small intestine triggered by gluten in genetically susceptible individuals. Diagnosis is made by serologic testing and upper endoscopy with small bowel biopsy in most individuals. Celiac patients may present with abdominal pain or nonspecific gastrointestinal complaints that result in radiologic imaging before diagnosis of celiac disease.

Copper levels in patients with celiac neuropathy.

Objective: Neurological complications of celiac disease (CD) include neuropathy, myeloneuropathy, and cerebellar degeneration. The cause of neuropathy in patients with CD is not known. Prior publications describe copper deficiency in CD patients with myeloneuropathy and neuropathy and posit that hypocupremia is the cause of these neurological conditions.

Sex and racial disparities in duodenal biopsy to evaluate for celiac disease.

Background: Celiac disease (CD) is common but underdiagnosed in the United States. Serological screening studies indicate that, although CD occurs at the same frequency in both sexes, women are diagnosed more frequently than men (2:1). CD is less frequently diagnosed among black patients, though the seroprevalence in this group is not known.

Quantitative estimates of motility from videocapsule endoscopy are useful to discern celiac patients from controls.

Background: Prior work has shown that videocapsule endoscopy image features are a useful tool for quantitatively distinguishing the intestinal mucosal surface of untreated celiac patients from that of controls. The use of dynamic estimates of wall motility may further help to improve classification.

Methods: Videocapsule endoscopy clips (200 frames each, 2 frames/s, 576 × 576 pixels/frame) were acquired at five small intestinal locations in 11 untreated celiac patients (celiacs) and ten controls.

Transformation of videocapsule images to detect small bowel mucosal differences in celiac versus control patients.

Background: Videocapsule endoscopy can be useful to detect small intestinal pathology in celiac disease patients. However, presence of extraneous features including air bubbles and opaque fluids can complicate the analysis. A technique for quantitative analysis of videocapsule images is presented that is robust to presence of extraneous features.

Variability in small bowel histopathology reporting between different pathology practice settings: impact on the diagnosis of coeliac disease.

Background And Aims: Coeliac disease (CD) diagnosis requires the detection of characteristic histological alterations of small bowel mucosa, which are prone to interobserver variability. This study evaluated the agreement in biopsy interpretation between different pathology practice types.

Methods: Biopsies from community hospitals (n=46), university hospitals (n=18) and commercial laboratories (n=38) were blindly assessed by a pathologist at our institution for differences in histopathology reporting and agreement in diagnosis of CD and degree of villous atrophy (VA) by κ analysis.

Increased sedation requirements during endoscopy in patients with celiac disease.

Background: Celiac disease (CD) is associated with increased rates of neuropsychiatric disease and irritable bowel syndrome, and patients may exhibit visceral hypersensitivity.

Aim: The purpose of this study was to determine whether patients with CD have increased sedation requirements during endoscopic procedures.

Methods: In this retrospective cohort study, we identified CD patients undergoing either a colonoscopy or esophagogastroduodenoscopy (EGD), but not a dual procedure.

Robust spectral analysis of videocapsule images acquired from celiac disease patients.

Background: Dominant frequency (DF) analysis of videocapsule endoscopy images is a new method to detect small intestinal periodicities that may result from mechanical rhythms such as peristalsis. Longer periodicity is related to greater image texture at areas of villous atrophy in celiac disease. However, extraneous features and spatiotemporal phase shift may mask DF rhythms.

Advances in small bowel imaging.

The small intestine has been difficult to examine by traditional endoscopic and radiologic techniques. Within the past 10 years, advances have led to an explosion of technologies that facilitate examination of the entire small intestine. Wireless video capsule endoscopy, deep enteroscopy using balloon-assisted or spiral techniques, computer tomography (CT) and magnetic resonance (MR) enterography have facilitated the diagnosis, monitoring, and management of patients with small intestinal diseases.

Quantitative assessment of endoscopic images for degree of villous atrophy in celiac disease.

Background: The degree of villous atrophy in celiac disease is difficult to assess at endoscopy. We sought to develop a quantitative technique for the evaluation of villous atrophy in endoscopic images.

Method: In ten celiac patients as identified by standard endoscopy with biopsy, and ten control patients, standard and videocapsule endoscopic images of the duodenum were digitized.

Classification of videocapsule endoscopy image patterns: comparative analysis between patients with celiac disease and normal individuals.

Background: Quantitative disease markers were developed to assess videocapsule images acquired from celiac disease patients with villous atrophy, and from control patients.

Method: Capsule endoscopy videoclip images (576 x 576 pixels) were acquired at 2/second frame rate (11 celiacs, 10 controls) at regions: 1. bulb, 2.

Distinguishing patients with celiac disease by quantitative analysis of videocapsule endoscopy images.

Background: Although videocapsule endoscopy images are helpful in the evaluation of celiac disease, their interpretation is subjective. Quantitative disease markers could assist in determining the extent of villous atrophy and response to treatment.

Method: Capsule endoscopy images were acquired from celiac patients with small bowel pathology (N=11) and from control patients (N=10).