http://www.celiac.com/articles/23403/1/ ... Page1.html
Thanks for translating this study.
Tex, Can you put this study into everyday language?
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
Tex, Can you put this study into everyday language?
MC diagnosed 2007
Well, it's kind of tough to put that study into "everyday" language, but here goes:
First off, here's the original research article, published in the August, 2013 issue of Gastroenterology:
http://www.gastrojournal.org/article/S0 ... 6/fulltext
Note that this project involved a very select group of subjects. Not a single one of us on this discussion board would have qualified as a subject for the study.
Only IBS patients were eligible, and in order to qualify as a subject for this research, an individual had to meet the Rome III criteria for IBS. The Rome III criteria for IBS requires that a patient must display the symptoms of recurrent abdominal pain or discomfort, and a marked change in bowel habit for at least six months, with symptoms experienced on at least three days of at least three months. And 2 or more of the following conditions must apply:
Pain is relieved by a bowel movement
Onset of pain is related to a change in frequency of stool
Onset of pain is related to a change in the appearance of stool.
Anyone who did not meet all these conditions was excluded from the study. Furthermore, all patients who had any significant GI disease (such as an inflammatory bowel disease, or cirrhosis) were excluded from the study. In addition, any patient who used NSAIDs, corticosteroids, systemic immunosuppressants, admitted to or showed signs of excessive alcohol intake, or who showed signs of having poorly-controlled psychiatric issues, were also excluded from the study. And of course anyone who met the criteria for celiac disease was excluded from participation in the study.
So who does that leave as possible subjects?
A rather unique group of individuals who have occasional minor GI symptoms, but who aren't actually ill.
So looking at the selection process, was this a meaningful study?
Probably, for anyone who meets the strict selection criteria.
Is this a meaningful study for us (or anyone else who has an IBD)?
Definitely not.
Why not?
Because besides the fact that having an IBD means that we were excluded from the study, we have always known that we need to minimize FODMAP foods while we are recovering. That's a no-brainer, because FODMAP foods are indigestible for most of us not only while we are reacting, but they continue to be a problem in most cases until we are well into recovery, and in some cases, forever.
But here's the kicker, that proves that the conclusions reached by that study definitely do not apply to us:
Even though we follow a very restrictive diet (and we probably follow it much more meticulously than was done in that study), we still react to gluten (in direct contradiction to the conclusions reached in that study).
The study conclusions state that if FODMAPs are removed from the diet, then gluten sensitivity is not a problem. That may well be true for the unique group of subjects involved with that study, but it definitely does not apply to us, because we still react to gluten, even in the total absence of FODMAP foods from our diet.
I realize that this is not a complete discussion of the entire research article, obviously, but as far as I can see, it covers everything that actually counts, by cutting to the chase. IOW, they were able to reach the conclusions that they published, simply by excluding anyone and everyone from their study, who might actually have non-celiac gluten sensitivity, namely people who have IBDs other than celiac disease.
At least that's the way that I see it.
Actually, this research topic has been discussed previously (a couple of times), but we never got down to the nitty-gritty details about why it is mostly irrelevant:
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=18724
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=18727
Tex
First off, here's the original research article, published in the August, 2013 issue of Gastroenterology:
http://www.gastrojournal.org/article/S0 ... 6/fulltext
Note that this project involved a very select group of subjects. Not a single one of us on this discussion board would have qualified as a subject for the study.
Only IBS patients were eligible, and in order to qualify as a subject for this research, an individual had to meet the Rome III criteria for IBS. The Rome III criteria for IBS requires that a patient must display the symptoms of recurrent abdominal pain or discomfort, and a marked change in bowel habit for at least six months, with symptoms experienced on at least three days of at least three months. And 2 or more of the following conditions must apply:
Pain is relieved by a bowel movement
Onset of pain is related to a change in frequency of stool
Onset of pain is related to a change in the appearance of stool.
Anyone who did not meet all these conditions was excluded from the study. Furthermore, all patients who had any significant GI disease (such as an inflammatory bowel disease, or cirrhosis) were excluded from the study. In addition, any patient who used NSAIDs, corticosteroids, systemic immunosuppressants, admitted to or showed signs of excessive alcohol intake, or who showed signs of having poorly-controlled psychiatric issues, were also excluded from the study. And of course anyone who met the criteria for celiac disease was excluded from participation in the study.
So who does that leave as possible subjects?
A rather unique group of individuals who have occasional minor GI symptoms, but who aren't actually ill.So looking at the selection process, was this a meaningful study?
Probably, for anyone who meets the strict selection criteria.
Is this a meaningful study for us (or anyone else who has an IBD)?
Definitely not.
Why not?
Because besides the fact that having an IBD means that we were excluded from the study, we have always known that we need to minimize FODMAP foods while we are recovering. That's a no-brainer, because FODMAP foods are indigestible for most of us not only while we are reacting, but they continue to be a problem in most cases until we are well into recovery, and in some cases, forever.
But here's the kicker, that proves that the conclusions reached by that study definitely do not apply to us:
Even though we follow a very restrictive diet (and we probably follow it much more meticulously than was done in that study), we still react to gluten (in direct contradiction to the conclusions reached in that study).
The study conclusions state that if FODMAPs are removed from the diet, then gluten sensitivity is not a problem. That may well be true for the unique group of subjects involved with that study, but it definitely does not apply to us, because we still react to gluten, even in the total absence of FODMAP foods from our diet.
I realize that this is not a complete discussion of the entire research article, obviously, but as far as I can see, it covers everything that actually counts, by cutting to the chase. IOW, they were able to reach the conclusions that they published, simply by excluding anyone and everyone from their study, who might actually have non-celiac gluten sensitivity, namely people who have IBDs other than celiac disease.
At least that's the way that I see it.
Actually, this research topic has been discussed previously (a couple of times), but we never got down to the nitty-gritty details about why it is mostly irrelevant:
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=18724
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=18727
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.