Doctor's response to me:
"September 28, 2011 at 11:16 am
Actually, there is no research to support that a food intolerance/allergy is responsible for Microscopic Colitis (either the lymphocytic or collagenous forms). There is, however, a propensity toward MC if you have celiac disease. Once celiac disease is ruled out, then so has any relation to food. Having said that, even going gluten free has not been the cure for MC, or I would already be cured!! Entocort, in combination with an enteral anti-inflammatory (ie Lialda, Pentasa) is the gold standard of treatment at the present time. I am also a big believer in adding probiotics to equilibrate the flora.
I am glad that removing the foods from you diet helped to control your symptoms. There is no research, however, that it is a universal treatment."
Tex, HELP!
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Tex, HELP!
DISCLAIMER: I am not a doctor and don't play one on TV.
LDN July 18, 2014
Joan
LDN July 18, 2014
Joan
O...M...G. Of course, food has no relationship to your intestinal health!! How ridiculous!Once celiac disease is ruled out, then so has any relation to food.
You're in the DC area, right? Time to find a new doc!!I may start going to the GW Center for Integrative Medicine, based on the advice of a dietician...
Hi Joan,
Well, what can I say. Most of what your doctor says is technically correct, except for the part about being cured - there is no known "cure" for MC, (though the clinical symptoms can be controlled, and the intestinal histology can be restored). And, of course, your doctor's claim that ruling out celiac disease rules out the possibility that food-sensitivities might be associated with MC, is obviously incorrect.
It's true that the GF diet usually doesn't control the symptoms, because additional food sensitivities are almost always present, and they have to be avoided, also, if full remission is to be attained by diet alone. The key is discovering all of them, and eliminating them 100%. And obviously there is no research that supports the claim that food-sensitivities are triggers for MC, simply because no one has ever done that research, (nor is anyone likely to do that research, because no one is likely to put up the money to do the study - Big Pharma certainly isn't going to fund it).
By the same token, there are absolutely no peer-reviewed, published research studies that support the claim that food-sensitivities are not associated with MC, either, so how can any doctor claim that there is proof that no connection exists? Obviously, they cannot - not legitimately, at least.
However, there are indeed published research studies that prove that food sensitivities are associated with Crohn's disease and ulcerative colitis, for example, so it is very likely that the same concept exists for MC. Here are a couple of examples of such studies:
Here are a couple of quotes from a study mentioned in Medical News Today, from 2007:
Here's a quote from a study published in the World Journal of Gastroenterology, in 2010:
If your doctor needs to see proof of the existence of non-celiac gluten-sensitivity, there's plenty of research supporting that concept. Here is a well-publicized example:
http://somvweb.som.umaryland.edu/absolu ... a=1474&z=5
This statement made by your doctor:
Regarding this statement made by your doctor:
You didn't mention what kind of help you were seeking. Is this what you were interested in?
Tex
Well, what can I say. Most of what your doctor says is technically correct, except for the part about being cured - there is no known "cure" for MC, (though the clinical symptoms can be controlled, and the intestinal histology can be restored). And, of course, your doctor's claim that ruling out celiac disease rules out the possibility that food-sensitivities might be associated with MC, is obviously incorrect.
It's true that the GF diet usually doesn't control the symptoms, because additional food sensitivities are almost always present, and they have to be avoided, also, if full remission is to be attained by diet alone. The key is discovering all of them, and eliminating them 100%. And obviously there is no research that supports the claim that food-sensitivities are triggers for MC, simply because no one has ever done that research, (nor is anyone likely to do that research, because no one is likely to put up the money to do the study - Big Pharma certainly isn't going to fund it).
By the same token, there are absolutely no peer-reviewed, published research studies that support the claim that food-sensitivities are not associated with MC, either, so how can any doctor claim that there is proof that no connection exists? Obviously, they cannot - not legitimately, at least.
However, there are indeed published research studies that prove that food sensitivities are associated with Crohn's disease and ulcerative colitis, for example, so it is very likely that the same concept exists for MC. Here are a couple of examples of such studies:
Here are a couple of quotes from a study mentioned in Medical News Today, from 2007:
Researchers from University College London have found compelling evidence for the first time to link food intolerances and serious illness.
A six-month programme has shown potential links with foodstuffs and Crohn's Disease, and ulcerative colitis.
The discovery could prompt an entire rethink in the medical profession across a range of conditions, from irritable bowel syndrome to migraine. To date, patient reports of intolerances have largely been seen as 'in the mind', and discounted.
http://www.medicalnewstoday.com/releases/76578.phpDr. Anton Emmanuel from UCL said: "The results were compelling. If there had been no link, one would have expected the results to be 50/50 - i.e. random chance association between (i) patients with objective measure of food sensitivity and (ii) subjective report of food sensitivity.
"For years, GPs - indeed most of the medical community - have perceived food intolerances as being largely in the mind, and this is probably the first research project to demonstrate that they could well be wrong. Indeed this points to what could be a direct link between food intolerance and patient symptoms."
Here's a quote from a study published in the World Journal of Gastroenterology, in 2010:
http://www.wjgnet.com/1007-9327/16/1442.pdfCONCLUSION
IBD has a multifactorial etiology but food sensitivity/intolerance appears to play a role, and the culpable foods vary on an individual basis. Techniques to identify food intolerance require refining. Progress has been made by looking at factors such as IgG4 responses to food antigens, but a large expanse of work exists in trying to determine people’s food sensitivities and the degree to which these affect disease activity. Without further research, it remains unclear whether dietary manipulation will continue to have a role solely in symptom control, or whether complete remission may be possible using these methods in combination with pharmacological agents.
If your doctor needs to see proof of the existence of non-celiac gluten-sensitivity, there's plenty of research supporting that concept. Here is a well-publicized example:
http://somvweb.som.umaryland.edu/absolu ... a=1474&z=5
This statement made by your doctor:
is nothing more than an assumption, with no basis in fact, (IOW, no research is available to back up that claim).Once celiac disease is ruled out, then so has any relation to food.
Regarding this statement made by your doctor:
We have never claimed that it is a universal treatment - we have simply maintained that it is typically the most effective and safest option available, for most people with MC.There is no research, however, that it is a universal treatment.
You didn't mention what kind of help you were seeking. Is this what you were interested in?
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
So, I guess all of us can go back to eating the way we did before our dx according to her. Show of hands for all in favor of that.-
mzh
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Well, Joan, it was nice to meet you through the doctor's forum; it's a small world!
Tex, I posted on the doctor's microscopic colitis forum blog too. Matter of fact, I may be the one who started the food allergy topic there. I did find a small study on a quick search that showed food as a cause of mic colitis.
As always, thanks for the great links!
Tex, I posted on the doctor's microscopic colitis forum blog too. Matter of fact, I may be the one who started the food allergy topic there. I did find a small study on a quick search that showed food as a cause of mic colitis.
As always, thanks for the great links!
Joan,
The following thought woke me in the middle of the night: If most celiac patients go for about a decade undiagnosed - even when there's testing for antibodies and villous atrophy - and THEN they are diagnosed with celiac... wasn't it true that even back when celiac was "ruled out" for them, they had a food problem? By this time, many of those undiagnosed celiac patients will have something else going on - maybe MC, maybe Sjogren's or issues affecting skin, thyroid, brain/neurology... and we now know gluten sensitivity is implicated in those issues as well.
It seems to me that this doctor's idea is nonsensical on the face of it. If the profession would pull up their socks and find some competence at diagnosing celiac - much less non-celiac gluten sensitivity - then they'd be standing on firmer ground when telling people that food isn't their issue. I read a story of a woman who was told "not celiac" every year for over a decade. Then - guess what!? - she was diagnosed. Gluten was her problem the whole time, obviously. Do you suppose her doctor said "we've been wrong the last 19 times?" I'm thinking not.
I realize this is another version of a rant I have ranted before.
The following thought woke me in the middle of the night: If most celiac patients go for about a decade undiagnosed - even when there's testing for antibodies and villous atrophy - and THEN they are diagnosed with celiac... wasn't it true that even back when celiac was "ruled out" for them, they had a food problem? By this time, many of those undiagnosed celiac patients will have something else going on - maybe MC, maybe Sjogren's or issues affecting skin, thyroid, brain/neurology... and we now know gluten sensitivity is implicated in those issues as well.
It seems to me that this doctor's idea is nonsensical on the face of it. If the profession would pull up their socks and find some competence at diagnosing celiac - much less non-celiac gluten sensitivity - then they'd be standing on firmer ground when telling people that food isn't their issue. I read a story of a woman who was told "not celiac" every year for over a decade. Then - guess what!? - she was diagnosed. Gluten was her problem the whole time, obviously. Do you suppose her doctor said "we've been wrong the last 19 times?" I'm thinking not.
I realize this is another version of a rant I have ranted before.
We potty people should unite against ignorant doctors. I think we should send each one of them a big box of cookies laced with ex-lax then put a note under the cookies that says....NOW YOU KNOW HOW WE FEEL! Wouldn't that be fun to watch. 
Hugs,
Hugs,
Denise
"Be the change you want to see in this world."
Mahatma Gandhi
"Be the change you want to see in this world."
Mahatma Gandhi