Oats Again - Or Still, As The Case May Be

[tex]

Hi All,

It appears that I'm not quite through with the oats, after all. It's been three weeks now, since I cut it back out of my diet, but I still have D. As you may recall, I stopped the test program, after about 6 weeks, because of the onset of D. I assumed that it would promptly clear up within a few days, but that has not been the case.

Fortunately, it's not secretory D - it's just minor, nothing-to-get-excited-about stuff, but still definitely D, (and if there's one thing we've all learned to recognize, it's D. LOL). I can't find anything to blame it on, except the oats, since that's the only alteration that I made to my diet. I must admit that I'm kinda surprised at it's tenacity.

Compared with the gluten in wheat, the avenin, (which is the prolamin in oats that is equivalent to the gluten in wheat), is only present to the extent of a small fraction of the percentage that gluten is present in wheat. Therefore, I expected only a mild reaction, if I did indeed react, (which is what happened, of course - my symptoms have been relatively mild, compared with the episodes earlier in my career, before I started the GF diet). I didn't expect a potential reaction to be so persistent, though - I assumed that it would only last for a few days at most. Apparently, I must have accrued some damage to my small intestine, to get such a persistent effect.

I have emailed Enterolab, (and I've spoken with someone there on the phone), to see if they have a test which might be able to detect antibodies to avenin, but the phone call was unproductive, and I haven't received a response to the email, yet. Frankly, I would be very surprised, if they had a test that would detect avenin.

This raises a big question in my mind, though, about all those celiacs who are gleefully eating oats, and are not reacting, (yet). Supposedly, they are monitoring their condition, by means of serum tests to detect antibodies to gluten, (and some of them are using occasional villous biopsies). I'm guessing that the serum test that they are using, was designed to detect antibodies to the specific gluten in wheat, (the reactive prolamin in wheat), and not a generic form of gluten, which all grains have, (even rice and corn, for example), so it is not likely to be able to detect antibodies to avenin. So how do they know that they are not slowly accumulating damage to the villi of their small intestine, because of the avenin in oats? The answer is probably that they do not know. It may take a long time to accumulate significant damage, because of the fact that avenin is present in such small quantities in oats. Logically, the tests couldn't detect generic grain gluten, because then it would detect the gluten in corn and rice, two things which most celiacs normally eat, without risk of damage.

The bottom line appears to be - currently there is no way to test for avenin sensitivity, which means that anyone with gluten sensitivity, who is eating oats, is sailing in uncharted waters, and relying strictly on obvious symptoms, to detect any possible adverse effects from the glutenous prolamin in oats. There are no lab tests to directly monitor any antibody production. At least that's my guess - we'll see if someone at Enterolab can contradict that opinion.

Love,
Tex

[starfire]

That is indeed scary, Tex. I'd be so happy if they stopped ALL that nonsense.

I'm really sorry your reaction hasn't stopped yet. It sure seems like a long time to have a mild reaction. I'm glad your symptoms aren't any worse.

Love, Shirley

[harvest_table]

Tex,

Hopefully, you haven't done any damage to your villi and here's to you pulling out of this flair soon.

This raises a big question in my mind, though, about all those celiacs who are gleefully eating oats, and are not reacting, (yet). Supposedly, they are monitoring their condition, by means of serum tests to detect antibodies to gluten, (and some of them are using occasional villous biopsies). I'm guessing that the serum test that they are using, was designed to detect antibodies to the specific gluten in wheat, (the reactive prolamin in wheat), and not a generic form of gluten, which all grains have, (even rice and corn, for example), so it is not likely to beable to detect antibodies to avenin. So how do they know that they are not slowly accumulating damage to the villi of their small intestine, because of the avenin in oats? The answer is probably that they do not know. It may take a long time to accumulate significant damage, because of the fact that avenin is present in such small quantities in oats. Logically, the tests couldn't detect generic grain gluten, because then it would detect the gluten in corn and rice, two things which most celiacs normally eat, without risk of damage.

Have you seen this 1 year study?

BACKGROUND: Evidence suggests the acceptability of oats in a gluten-free diet in coeliac disease. We investigated the impact of an oats-containing diet on quality of life and gastrointestinal symptoms. METHODS: Thirty-nine coeliac disease patients on a gluten-free diet were randomized to take either 50 g of oats-containing gluten-free products daily or to continue without oats for 1 year. Quality of life was assessed using the Psychological General Well-Being questionnaire and gastrointestinal symptoms using the Gastrointestinal Symptom Rating Scale. Small-bowel mucosal villous architecture, CD3+, alphabeta+, gammadelta+ intraepithelial lymphocytes, serum endomysial and tissue transglutaminase antibodies were investigated. RESULTS: Twenty-three subjects were randomized to the oats-containing diet and 16 to the traditional gluten-free diet. All adhered strictly to their respective diet. Quality of life did not differ between the groups. In general, there were more gastrointestinal symptoms in the oats-consuming group. Patients taking oats suffered significantly more often from diarrhoea, but there was a simultaneous trend towards a more severe average constipation symptom score. The villous structure did not differ between the groups, but the density of intraepithelial lymphocytes was slightly but significantly higher in the oats group. The severity of symptoms was not dependent on the degree of inflammation. Antibody levels did not increase during the study period. CONCLUSION: The oats-containing gluten-free diet caused more intestinal symptoms than the traditional diet. Mucosal integrity was not disturbed, but more inflammation was evident in the oats group. Oats provide an alternative in the gluten-free diet, but coeliac patients should be aware of the possible increase in intestinal symptoms.

http://www.ncbi.nlm.nih.gov/entrez/quer ... t=Abstract

Love,
Joanna

[tex]

Thanks Joanna,

No, I hadn't seen that report, but it's very interesting, isn't it. I certainly believe it, after my experience.

I wonder what it is that oats do, to cause the inflammation. Obviously, they do something adverse, but apparently researchers haven't discovered exactly what it is, yet. If oats don't damage the villi, and no antibodies show up in the blood, then that explains why celiacs who eat oats think that they're not reacting. The problem seems to be, that no one has defined the mechanisms of an avenin reaction, yet.

Incidentally, the report mentions that no increase in antibody levels was noted during the test. I'll just bet that the silly gooses were using the classic celiac tests, (which only detect wheat gluten). Of course, there was no increase in gluten antibodies, no one in the trial was ingesting wheat gluten. None of these guys seem to realize that they have to check for avenin antibodies, if the challenge involves oats, instead of wheat.

Thanks for bringing that to our attention. It certainly helps to shed some light on what is going on with oats.

Love,
Tex