GLUTEN sensitivity,
So when I told a group
I could hear them all thinking: "Another bozo doctor."
I was at a meeting of a vegetarian group that gathers one Saturday morning a month at The Loft, above Frederick's restaurant on Princess Anne Street in downtown Fredericksburg. At this meeting, Shirley Braden of the King George Celiac and Gluten Intolerance Group was making the presentation.
A sufferer herself, Braden told a fairly typical story of going for years undiagnosed, having terrible stomach cramps as a child and spending her life in the bathroom with diarrhea.
Only when she went to a slightly alternative doctor because of some obscure gynecological problems--and this doctor said, "I really think there's something else going on"--was she finally identified as being gluten-sensitive.
A UBIQUITOUS PROBLEM
Gluten is a protein found in rye, barley and most notably in wheat--so it is found in a huge array of foodstuffs that are part of the normal diet.
People who are sensitive to gluten develop damage to the small intestine when they eat it, which leads to diarrhea, abdominal pains and malabsorption of many vitamins, minerals and other nutrients.
There is also evidence that gluten sensitivity has an adverse interaction with the body's immune system that causes a form of so-called collagen-vascular disease.
This damages many other organs in the body, and one of Braden's handouts lists some 60-odd diseases that it claims can be improved by excluding gluten from your diet--diseases as varied as depression, dementia, cirrhosis, multiple sclerosis, seizures, kidney disease, infertility, joint pains, fibromyalgia and various cancers.
There appears to be an inherited predisposition to gluten sensitivity, so there is an increased prevalence of gluten sensitivity among family members.
Overall, the prevalence is 1-in-133, meaning there are
Yet 97 percent of those with gluten sensitivity are undiagnosed, according to the University of Chicago Celiac Disease Center.
A DIFFICULT DIAGNOSIS
"I can't tell you how many times I have had people tell me that their doctor said 'It's just a waste of time' doing
The get-together had something of the feel of a revivalist meeting of true believers, many of whom felt oppressed by the medical profession.
There is a tendency for gluten sensitivity/celiac disease to get lumped together with those diseases--including fibromyalgia, chronic fatigue syndrome and irritable bowel disease--that doctors often think of as having a strong psychosomatic element (or that they don't even believe in at all).
That frustrates patients. But to come to the defense of my medical brethren, I would point out that the symptoms of gluten sensitivity and celiac disease--such as gastrointestinal upset, fatigue and aches and pains--are very nonspecific.
There is also a tendency for patients with these kinds of illnesses to be slightly distrustful and anxious and to sometimes have quirky ideas. Often, the interaction with the doctor is not a good one. (Maybe this is a result of it being so hard to get anyone to take them seriously?)
To dispel the idea that this is a bunch of zealots: One study showed that it took
This is according to Dr. John Pope of the Louisiana State University Health System, who gave a presentation about it to the American Academy of Family Physicians' Annual Scientific
The main problem, points out Dr. Pope, is that there is no good test that will establish the diagnosis for sure.
There are blood tests of different types, and some people advocate the less-well-established stool test. A biopsy of the small intestine is often done. But even this doesn't always give a definitive answer.
So, many people skip this step and just go straight for treatment--by eliminating gluten from their diets.
YOU ARE WHAT YOU EAT
Treatment with a gluten-free diet requires knowledge, and possibly the help of a dietitian--though looking at a handout of 50 gluten-free foods you can eat, it doesn't really appear to be such a hardship. You can eat fresh fruit, vegetables, steak, Doritos, hot dogs, milk, most peanut butter, wine, scotch, cheese, Snickers bars and a whole lot more.
What you can't eat are things made from flour that contains wheat--which is,
Many people who change over to a gluten-free diet claim dramatic improvement and become passionate advocates. And if it's working for them, more power to them. I would encourage them to carry on.
But to once again play skeptic, I would point out that this is a very subjective business. I am unaware of any clinical trials on diets that would stand muster, and paying minute attention to what you eat must have a strong placebo effect.
If you feel good, maybe it doesn't matter why. And overall, the vegetarians, vegans and gluten-sensitives at The Loft that morning seemed to be a healthy bunch--probably because they pay attention to their diet, in contrast to the rest of society.
As more is found out about gluten sensitivity and celiac disease, and especially when a more precise diagnostic tool is found, I fancy attitudes will change.
But even as a member of the medical profession, I was warmly welcomed at this get-together, and I was included in a very healthy potluck lunch at the end that was both tasty and filling--even though the dishes were gluten-free, and there wasn't a morsel of meat to be found.
Dr. Patrick Neustatter is a family practitioner in North Stafford. Dr. Patrick Neustatter can be reached
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Dr. Patrick Neustatter is a family practitioner in North Stafford. |