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A Gastroenterologist’s Personal Journey Down the Gluten Rabbit Hole

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Celiac disease and non-Celiac Gluten Sensitivity (NCGS)

Gluten intolerance resulting in symptoms and illness similar to celiac disease (CD) without meeting diagnostic criteria for CD was a new concept when I first wrote this article in 2006. However, the condition known as non-celiac gluten sensitivity (NCGS) for many physicians, even gastroenterologists to swallow to an increasingly recognized, written about and studied one in mainstream gastroenterology. While celiac dissease affects 1% of the population worldwide it is accepted that NCGS affects as many as 10% the population albeit transiently. I would propose it may affect as high as 30% of the population though mildly and transiently.

Wheat gluten as a cause of illness

Gluten ingestion is an avoidable, treatable, and reversible cause of illness and/or varied digestive and non-digestive symptoms in many people https://www.stuartakermanmd.com/. It is believed to be a contributing factor in the rising epidemic of autoimmune diseases. Many physicians resist these concepts finding them either unbelievable, unacceptable or both. I believe that their rejection is neither rational nor helpful. It may be reasonable to reject them for cultural or financial reasons but I don’t believe they can legitimately be rejected based on scientific grounds or experience any longer.

Celiac disease not rare and is often missed as a diagnosis

Celiac disease is not rare. CD affects 1 in 100 people in the world. Yet the diagnosis of CD is still frequently missed and/or delayed. It is a common disease that is often undiagnosed or misdiagnosed. It may even be the most common autoimmune disorder. Though the risk is largely genetic, it is preventable by simply avoiding gluten. Autoimmune diseases associated with CD may also be preventable by avoiding gluten.

What doctors remember from medical school about Celiac disease

When I was in medical school over thirty years ago, I was taught that CD was rare. In residency we were shown photos of short, emaciated children with skinny limbs and pot-bellies. We were told that their medical history included symptoms of profuse, watery, floating, foul-smelling diarrhea, and iron deficiency anemia. The picture and story was burned into the hard drive of our brains, not necessarily because anyone believed we would see someone with CD in our practice, but because CD was considered rare and odd enough that it was a favorite board examination question. That image and story remains in the mind of most physicians, preventing them from seeing CD in a much broader light.

 

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