The primary area of injury in celiac disease is the small bowel but there may be a relationship between what happens in the small bowel and the colon or large bowel. There are very large numbers of bacteria in the colon. Most of these are beneficial and actually confer health benefits. When these good bacteria thrive, they suppress the bad bacteria, which are present in the colon. What has been found is that celiac patients, in fact anyone on a gluten-free diet, have an altered make-up of bacteria in the colon which favors the unwanted bacteria.
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