Angy,
It makes a lot of sense. I agree with you, and trying to convince the hard-headed mainstream GI docs that celiac disease can indeed be diagnosed before it fully develops, is exactly what Dr. Fine has been trying to do, for over 10 years. If more research continues to point in the same direction as his discoveries, then eventually, even the hard-heads will begin to see the light, (I hope).
Harma,
I have a hunch that some of the celiacs who develop MC, may be people who either occasionally "slip" on their diet, or who are unaware that some of the foods in their diet contain gluten, (IOW, they are not being adequately treated), but I suspect that many of the celiacs who develop MC, are those who were diagnosed so late in the game, that they have developed additional food intolerances, and as Luce pointed out, those foods, (such as milk, or soy), continue to damage the intestines, even though these people are following a strict GF diet.
Many, many members of celiac discussion boards, discuss their issues with other food intolerances, as if other food intolerances is a natural part of celiac disease. It is not. Classic celiacs should
not have additional food intolerances. By definition, the GF diet should bring remission for anyone with celiac disease, and the GF diet should maintain remission, indefinitely.
I believe that the additional food intolerances are the distinguishing characteristic between "classic" celiacs, and those who also have MC.
Dr. Fine has mentioned, (years ago), in some of his articles, that refractive celiac disease, (where a patient does not respond to the GF diet), is almost always due to MC. Obviously, most of those celiacs who talk about their other food intolerances, are unaware of his findings, and they don't even recognize the paradox in the statements that they make.
harma wrote:On the other hand is there any evidence that MC people later on in life develop a CD if they keep on eating gluten?
I'm not aware of any research on this, but I would think that if someone with MC, who is sensitive to gluten, continues to eat gluten, then they certainly might eventually develop "classic" CD. I'm thinking that we might have one or two members who were first diagnosed with MC, and then later with CD, but, of course, in most cases, the CD diagnosis comes first, and the GI doc never even bothers to look for MC, unless the patient continues to complain about symptoms that are not resolved by the GF diet. I think there are probably many, many, undiagnosed cases of MC in the world, simply because once a GI doc reaches a diagnosis of CD, they don't bother to look any further, IOW, they don't routinely do a colonoscopy with biopsies, when looking for CD. Unless a GI doc suspects cancer, when a patient has a positive blood test, then the GI doc will do an upper endoscopy, (with biopsies of the small intestine), to confirm the diagnosis, and they won't see a need to do a "lower" endoscopy, if the "upper" shows villus damage consistent with celiac disease. Even if they should do a colonoscopy, many docs don't take biopsies, unless they suspect cancer, or MC, (but they rarely suspect MC, of course).
Tex