"A major problem for people with gluten sensitivity is that physicians using tests for celiac disease simply state that the client does not have celiac disease, leading uninformed patients to fend for themselves. Symptoms continue, but the yet unanswered question remains: 'Are people with gluten sensitivity at risk for the same long-term, serious systematic side effects of celiac disease?'"
Bonnie: The answer is a resounding yes. We hear this frustration from clients on a weekly basis.
"It is time to not only recognize, but to treat and further research gluten sensitivity, as unconfirmed environmental factors continue to spread this problem further into the general population."
Steve: These quotes appear in an amazing report from this month's Expert Review of Gastroenterology and Hepatology, thoroughly validating what we have known for years. Here are a few more highlights from the finest report on gluten intolerance (they call it sensitivity by the way) that we have read to date.
--end portion from eNewsletter--
"Nonceliac gluten sensitivity is a separate problem from celiac disease, which emerged prior to 2008. Until this time, the medical establisment only officially recognized gluten as being problematic in people with celiac disease. It is clear that many health-insurance companies lack both the name and reimbursement coding for gluten sensitivity."
Steve: This is a huge problem when clients are trying to get reimbursed.
"People with gluten sensitivity test negative for celiac disease and wheat allergy, but experience resolution of symptoms on a gluten-free diet."
Bonnie: Clinically evident on a weekly basis here.
"It is suggested that the debate on whether or not gluten sensitivity even exists is interfering with the very real need of it being recognized, treated and researched. It is time to recognize the numerous clinical cases of gluten sensitivities in adults and the need to formally confirm this through research. In addition, a renewed recognition needs to occur of the already medically established fact that a second bimodal wave of celiac disease can occur in adults, and not just in infants and children under 3 years of age with the classic symptoms of stunted growth, emaciation, anemia, pot-belly, diarrhea and foul smelling, pale stools. The failure to recognize that celiac disease can also occur later in life, results in a time to diagnosis that is often up to a decade. Is the same scenario occurring for patients with gluten sensitivity?"
Bonnie: This is not something you can usually grow out of. And it can happen when you are older because the damaging effects add up over time.
"What is Causing the Gluten Sensitivity Problem? Human Genetics, Plant Genetic Modification, Wheat Breeding, Improving Gluten Strength, Gluten as a Food Additive, Contaminated Gluten, Hormonal influences, Intestinal Infections, and Allergic Disease."
Steve: A very good list, with human genetics being the biggest, of course.
"The curious suggestion that such a gluten-free diet is 'dangerous' is not justified considering the serious side effects associated with celiac disease. Any 'problems' are easily addressed by referring patients to a dietitian, who will customize the diet and possibly recommend specific dietary supplements such as fiber and calcium.
Bonnie: The key is to replace the gluten-related calories optimally for your individual needs.
Benefits from an elimination diet may also be maximized by minimizing food allergens, utilizing digestive enzymes and providing omega-3 fatty acids or other dietary supplements. Additional dietary modifications may include foods that decrease inflammation, probiotics influencing gut microflora concentrations and limiting carbohydrates."
Bonnie: What a novel idea?
"Treatment of Gluten Sensitivity: The current problem of ruling out celiac disease and not recommending a gluten-free diet for gluten-sensitive individuals needs to be corrected. Perhaps patients who are sure that certain foods trigger their symptoms, but are not sure of the causative factor(s), may be best served by providing them a test elimination diet. Patients need to be made aware of these side-effects of gluten so that they understand that this is not just a 'diet' in which gastrointestinal problems are the only consequence of consuming gluten. Currently, this is not the case in medical practice. In the best interest of these patients, referrals to dietitians are recommended. Gluten is not only found in wheat products, but in many hidden locations in the diet that are not easily communicated in a short office visit."
"Five Year View: Until gluten sensitivity is acknowledged, we cannot move together toward solving this problem. The gluten-sensitivity problem will continue in its current amoeba-like state, where no questions are being asked, let alone answered. It was the purpose of this paper to finally ask some of those questions, and ask more people to join in on the arduous task of answering them. In the meantime, gluten sensitivity will continue to spread silently through the unaware population, which includes many clinicians and researchers."
Bonnie and Steve: Could not have said it better ourselves.
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