Hi Sheila,
IMO the problem is due to 2 handicaps that Dr. Green is operating under. First, he is the Director of The Celiac Disease Center at Columbia University, and he's a Professor of Clinical Medicine at the College of Physicians there. But the biggest obstacle is probably the fact that he is considered to be a bona fide celiac expert. Physicians have already spent around 2,000 years unsuccessfully trying to understand celiac disease, so most of the "experts" are so shackled by obsolete, botched research, and mistaken conclusions and beliefs that they are almost forced to just go with the flow, and try to keep from rocking the boat too far at any point in time, hoping for an eventual breakthrough.
They should just throw it all out and start over, IMO. As a high-ranking and respected educator, he can't afford to stray too far from conventional wisdom, and of course conventional wisdom says that MC does not respond to a GF diet. Of course it doesn't, the other food sensitivities have to be removed also. And refractive celiac disease patients are in the same boat. By failing to also recommend the removal of casein and possibly other foods along with the GF diet, celiac "experts" (though obviously not all of them) pretty much guarantee that if a patient who is refractive to treatment doesn't already have MC, she or he is certainly headed in that direction.
And yes, I certainly agree with you that collagenous sprue and collagenous colitis are indistinguishable. There's no proof of that of course, and I'm beginning to wonder if anyone will ever get around to trying to correct that mistake, but these 2 ducks just happen to walk, and quack, and pretty much everything else as if they are identical twins.
Doctors don't like to admit that they created a new disease (collagenous colitis) when it actually was not new, and the problem with this situation is that collagenous sprue was apparently incorrectly described originally (as a disease of the small intestine), and collagenous colitis was incorrectly described as a disease of the colon (only). Trying to correct it may turn out to be Mission Impossible because collagenous sprue was originally described in 1947 — 29 years before collagenous colitis was described. Medical authorities are presumably flummoxed because the diseases are described as affecting different segments of the bowel, when virtually any patient who has MC can tell you that the disease clearly affects both the small and large intestine. Hell, I haven't had a colon in over 5 years now, and it was disconnected (leaving a distal stub) 4 years prior to that. And yet I had a reaction last November that could only be attributed to MC, because not only was my small intestine affected, but so was that short stub that was disconnected over 9 years ago.
So I don't see that mistake ever being changed in the medical records, but maybe they will surprise me some day.
Anyway, those are my random thoughts on Dr. Green's dilemma. Surely, in his position he has to tread softly so as not to rock the boat too much and bring down the wrath of the entire celiac industry upon his shoulders. Can you imagine all the ruckus when all of his previous students realized that they had been taught invalid principles.
Tex