New Paper by Dr. Fasano on Trace Gluten Contamination

[Rosie]

I came across this paper by Dr. Fasano's lab last month, and thought that it would be noticed and posted on the forum. But since it hasn't I thought that I would point it out as there has been a lot of discussion about gluten cross contamination.

He is the acknowledged clinical expert on Celiac Disease, and he gets referrals of the more difficult cases. There have always been a small proportion of CD patients who don't respond to a gluten free diet, and there have been a number of theories. Most commonly, patients think that they are being contentious about a gluten free diet, but on having a dietitian take a closer look, they are getting gluten from some food or medicine that they thought were safe. Another possibility is that they are sensitive to other foods. On this forum we know that there are people who have both CD and MC, so that elimination of other items such as milk or soy may be required. And of course there may be some unknown complication.

Here is a summary of the article:

http://www.biomedcentral.com/content/pd ... -13-40.pdf


Title: Trace gluten contamination may play a role in mucosal and clinical recovery in a subgroup of diet-adherent non-responsive celiac disease patients.

Dr. Fasano wanted to take a closer look at these refractory CD patients. He identified a group of 17 diagnosed CD patients who were determined to be following a strict gluten free diet after a careful examination of what they were eating. His hypothesis is that these refractory CD patients are a subset that have more sensitivity to gluten than the average CD patient, and that cross-contamination with gluten in their diet was preventing them from getting rid of their symptoms. So he put them on what is called the "Gluten Contamination Elimination Diet" for 3 to 6 months. He found that 14 out of the 17 patients responded to this diet with the elimination of symptoms. He also found that after this time on the elimination diet, 11 of the responders were able to return to their normal gluten free diet without a return of symptoms.

The details of the "Gluten Contamination Elimination Diet" are provided in the paper. No grains except rice are allowed, and only fresh fruit and vegetables. Some dairy is allowed, like unflavored milk, yogurt butter and aged cheeses, but no processed cheeses. Nothing frozen, canned or dried is allowed. No processed meats either.

Of course none of this is unfamiliar to us, as each of us has found by trial and error our own individual sensitivities. What the article does point out, though, is that when you think that you are being very diligent but are still having symptoms, there is a good chance that a high sensitivity to gluten cross-contamination is the culprit. And there is hope, according to the article, that after a few months of the "Gluten Contamination Elimination Diet" you might be able to resume eating foods that have a potential for cross-contamination without reacting.

This article reinforces my commitment to eating "real", not processed foods and minimizing my consumption of grains other than rice.

Rosie

[Zizzle]

Very interesting. It does concern me that he doesn't acknowledge the possibility that other food sensitivities may be involved...that it all boils down to gluten.