Sunday, February 26, 2012
At last, consensus is consolidating in the murky waters of gluten-related-illness.
Fifteen international-celiac-doctors have put forward a consensus statement on the “new nomenclature and classification of gluten-related-illness”.
I have previously named this set of illnesses “The Gluten Syndrome”.
Here are the 3 steps in my gluten logic:
a) If, gluten sensitivity is common: perhaps affecting over 10% of the population);
b) If, gluten-related illnesses are varied and have multiple symptoms: a quote from the consensus paper emphasises this “The symptoms in GS may resemble those associated with celiac disease (CD) but with a prevalence of extra-intestinal symptoms, such as behavioral changes, bone or joint pain, muscle cramps, leg numbness, weight loss and chronic fatigue. Their symptoms include abdominal pain (68%); eczema and/or rash (40%); headache (35%); ‘foggy mind’ (34%); fatigue (33%); diarrhea (33%); depression (22%); anemia (20%); numbness in the legs, arms or fingers 20%; and joint pain (11%)”;
c) If, there is no definitive diagnostic test for gluten sensitivity: the Consensus paper goes on to say “However, currently there are no laboratory biomarkers specific for GS. Usually the diagnosis is based on exclusion criteria; an elimination diet of gluten-containing foods followed by an open challenge is most often used to evaluate whether health improves with the elimination or reduction of gluten from the patient's diet;
d) And if there is no harm from going on a gluten-free diet; gluten-free is healthy.
Then the logical conclusion is that anyone, with any symptoms that are chronic and unexplained (that is they do not have a definite diagnosis) should be put onto a gluten-free diet for a clinical trial for three months or more.
Whatever the test results and whatever the symptoms, a response to a gluten-free diet suggests that their illness is gluten related (some people might demand a double blind food challenge).
Up until now, most gluten/celiac doctors have dismissed non-celiac patients as having a placebo response to a gluten-free diet. This is clearly not the case.
The above logic means that all people with undiagnosed illnesses should be given a trial of gluten-free. This is likely to have huge health benefits and wide ramifications on the management of ill health.
Already 10% of Australians are adopting a gluten-free diet.
It is my prediction that in another generation most people who wish to remain well will also adopt a gluten-free diet.
Look forward to comment
Dr Rodney Ford