Hi all! I found this paper that researches gluten sensitivity and separates it from Celiac disease. Particularly, it had interesting stuff about intestinal permeability. I thought it was enlightening. It's good to see that researchers are becoming aware of gluten as something that can be a problem even when Celiac disease is absent. It appears to be available online at no charge, so here is the URL:
http://www.biomedcentral.com/1741-7015/9/23
--T
For science types
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Dear Tnelson,
Thanks for posting the link to the research. It is interesting and good that GS is being taken seriously.
Best, Ant
Thanks for posting the link to the research. It is interesting and good that GS is being taken seriously.
I think these are small sample bases (26,42,39) to make comparative quantitative conclusions from.A total of 26 GS patients diagnosed according to the criteria outlined above were enrolled. For comparison, 42 patients with active CD were recruited according to the modified 2004 criteria of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) [10]. Finally, 39 control subjects were enrolled from among individuals undergoing upper endoscopy for dyspepsia.
My bold. I wonder if this mean people with MC (an inflammatory bowel disease) were ruled out of the sample? Or is the GS sample of 26 people some mix of those with MC and not?GS patients are defined as those patients in which CD, wheat allergy and other clinically overlapping diseases (type 1 diabetes, inflammatory bowel diseases and Helicobacter pylori infection) have been ruled out and whose symptoms were triggered by gluten exposure and alleviated by gluten withdrawal.
Best, Ant
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"Softly, softly catchee monkey".....
"Softly, softly catchee monkey".....
Ant,
It's my understanding that they were ruled out. That's the main reason why the research conclusions are of little value. Who has food sensitivities? People who have autoimmune diseases, of course.
The following statement is proof that they ruled out everyone who had MC, because virtually everyone who has MC has lymphocytic infiltration in their small intestine. Many have a Marsh 1 level of damage. My book contains references to verify that.
It's my understanding that they were ruled out. That's the main reason why the research conclusions are of little value. Who has food sensitivities? People who have autoimmune diseases, of course.
The following statement is proof that they ruled out everyone who had MC, because virtually everyone who has MC has lymphocytic infiltration in their small intestine. Many have a Marsh 1 level of damage. My book contains references to verify that.
TexGS patients are unable to tolerate gluten and develop an adverse reaction when eating gluten that usually, and differently from CD, does not lead to small intestinal damage.
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.
Yes, they probably ruled out MC right off the bat (sigh).
Question: I had an upper endoscopy but didn't hear about intraepitheial lympocytes (IELs) in the small intestine. I wonder if that's just because they didn't happen to stain for IELs in the small bowel--only in the large intestine? Tex, do you happen to know whether IEL staining in the small bowel is standard practice? I could well believe I have small intestinal IELs.
I saw this research paper mostly as part of the effort to get the medical community to accept the notion that gluten can be a problem EVEN IN THE ABSENCE of celiac disease, which is a first step to connecting gluten to other digestive disorders such as MC. My doctor, at least, completely pooh poohed the idea that gluten could play *any* role in *any* GI problem in the absence of full-blown celiac disease. After I got the LC diagnosis but before I found this community, I specifically asked him whether it might be beneficial to give up gluten. He was entirely dismissive of the idea. I've seen other posts on this board that note that now Medscape recognizes GS, which is a step in the right direction.
--T
Question: I had an upper endoscopy but didn't hear about intraepitheial lympocytes (IELs) in the small intestine. I wonder if that's just because they didn't happen to stain for IELs in the small bowel--only in the large intestine? Tex, do you happen to know whether IEL staining in the small bowel is standard practice? I could well believe I have small intestinal IELs.
I saw this research paper mostly as part of the effort to get the medical community to accept the notion that gluten can be a problem EVEN IN THE ABSENCE of celiac disease, which is a first step to connecting gluten to other digestive disorders such as MC. My doctor, at least, completely pooh poohed the idea that gluten could play *any* role in *any* GI problem in the absence of full-blown celiac disease. After I got the LC diagnosis but before I found this community, I specifically asked him whether it might be beneficial to give up gluten. He was entirely dismissive of the idea. I've seen other posts on this board that note that now Medscape recognizes GS, which is a step in the right direction.
--T
Your doctor is typical of many GI specialists -- they simply aren't yet aware of the connection between IBDs and food sensitivities (except for celiac disease).
I really don't know what a pathologist's primary goals are when analyzing small intestinal biopsies. IELs are only of interest for a Marsh 1 or 2 level of damage. If the pathologist is trying to rule out celiac disease, he or she may only look for villus atrophy (which would be a Marsh 3 or 4 level) and in that case they might not even bother to count IELs at the tip of the villi if no atrophy is evident (but I am only guessing). Their routine would surely depend on the instructions handed down by the GI specialist who submitted the samples for analysis. In general, I would think that they would do an IEL count unless the villi were completely flattened.
Did you see the pathology report, or did you only see or hear your gastroenterologist's interpretation of it? Often, such information is in the pathology report, but the GI doc never mentions it.
Tex
I really don't know what a pathologist's primary goals are when analyzing small intestinal biopsies. IELs are only of interest for a Marsh 1 or 2 level of damage. If the pathologist is trying to rule out celiac disease, he or she may only look for villus atrophy (which would be a Marsh 3 or 4 level) and in that case they might not even bother to count IELs at the tip of the villi if no atrophy is evident (but I am only guessing). Their routine would surely depend on the instructions handed down by the GI specialist who submitted the samples for analysis. In general, I would think that they would do an IEL count unless the villi were completely flattened.
Did you see the pathology report, or did you only see or hear your gastroenterologist's interpretation of it? Often, such information is in the pathology report, but the GI doc never mentions it.
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.