gluten sensitivity vs. celiac disease
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gluten sensitivity vs. celiac disease
Is all gluten sensitivity celiac disease which has just not been diagnosed? or is there a difference?
Hi Temple,
I copied your question to the General Message Board where more of the members read.
Love,
Mars
I copied your question to the General Message Board where more of the members read.
Love,
Mars
"Let us rise up and be thankful, for if we didn't learn a lot today, at least we learned a little, and if we didn't learn a little, at least we didn't get sick, and if we got sick, at least we didn't die; so, let us all be thankful." -- Buddha
That's a very good question, and the answer may depend on who is answering the question.
Based on genetic evidence, my answer would be that no, all gluten sensitivity is not undiagnosed celiac disease. The reason for that opinion, is based on the fact that gluten sensitivity, as often seen with MC, is caused by different genes, than the genes which commonly are linked with celiac disease. That said, many of us with MC, often have several types of genes that are linked with both conditions. A few of us actually have celiac disease, while most of us do not.
It probably can be generally concluded, that those of us with both types of genes are likely to be more highly gluten sensitive than those with only the non-celiac type genes. I am unaware that this has ever been reliably demonstrated, however, so this is strckly speculation on my part. I am one of those lucky individuals who has both types of genes. Sigh.
According to Dr. Fine, based on on all his research, the long-term accumulated damage caused by gluten to those of us who are sensitive, may be just as severe as the intestinal damage that celiacs experience. It's unclear, however, whether we are also at risk of all the other dire consequences of untreated celiac disease, if we should choose to not try to control our symptoms, (such as lymphoma, diabetes, spleen damage, etc.) The implications are so strong, however, that it's difficult to write them off as ungrounded.
Tex
Based on genetic evidence, my answer would be that no, all gluten sensitivity is not undiagnosed celiac disease. The reason for that opinion, is based on the fact that gluten sensitivity, as often seen with MC, is caused by different genes, than the genes which commonly are linked with celiac disease. That said, many of us with MC, often have several types of genes that are linked with both conditions. A few of us actually have celiac disease, while most of us do not.
It probably can be generally concluded, that those of us with both types of genes are likely to be more highly gluten sensitive than those with only the non-celiac type genes. I am unaware that this has ever been reliably demonstrated, however, so this is strckly speculation on my part. I am one of those lucky individuals who has both types of genes. Sigh.
According to Dr. Fine, based on on all his research, the long-term accumulated damage caused by gluten to those of us who are sensitive, may be just as severe as the intestinal damage that celiacs experience. It's unclear, however, whether we are also at risk of all the other dire consequences of untreated celiac disease, if we should choose to not try to control our symptoms, (such as lymphoma, diabetes, spleen damage, etc.) The implications are so strong, however, that it's difficult to write them off as ungrounded.
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.
Temple
This is indeed an interesting question. In fact it it a question that seems to be on the cutting edge of current research.
From my search along with what the other great members on this sight we have found that their is a broad spectrum of gluten sensitivity. I would put Celiac Disease at the top of the pyramid in that small intestine biopsies show flattened villi , blood tests show antibodies in the blood and genetic testing shows both genes for the disease. The classic extreme symptoms for Celiac disease are malabsorbtion, extreme weight loss and failure to thrive in children along with many others.
Dr. Fine, a leading researcher on the subject , has done a great job of explaining how their is a much broader spectrum of gluten sensitivity and that even though no antibodies can be found by current blood tests, biopsies do not show damage to the small intestine an auto immune response to gluten can still be creating many problems even though the gold standard, classic symptoms that doctors are curently using to diagnose it mentioned above are not present.
I highly recommend reading this essay that explains this broad spectrum better than I can.
http://www.finerhealth.com/Essay/
You might find a lot of other useful information about the broad spectrum of gluten sensitivity on the rest of his sight
http://www.finerhealth.com/Educational_ ... nsitivity/
What a great question in that the same kind of thinking lead me to finding answers for myself.
Matthew
This is indeed an interesting question. In fact it it a question that seems to be on the cutting edge of current research.
From my search along with what the other great members on this sight we have found that their is a broad spectrum of gluten sensitivity. I would put Celiac Disease at the top of the pyramid in that small intestine biopsies show flattened villi , blood tests show antibodies in the blood and genetic testing shows both genes for the disease. The classic extreme symptoms for Celiac disease are malabsorbtion, extreme weight loss and failure to thrive in children along with many others.
Dr. Fine, a leading researcher on the subject , has done a great job of explaining how their is a much broader spectrum of gluten sensitivity and that even though no antibodies can be found by current blood tests, biopsies do not show damage to the small intestine an auto immune response to gluten can still be creating many problems even though the gold standard, classic symptoms that doctors are curently using to diagnose it mentioned above are not present.
I highly recommend reading this essay that explains this broad spectrum better than I can.
http://www.finerhealth.com/Essay/
You might find a lot of other useful information about the broad spectrum of gluten sensitivity on the rest of his sight
http://www.finerhealth.com/Educational_ ... nsitivity/
What a great question in that the same kind of thinking lead me to finding answers for myself.
Matthew
Hi Temple,
This is indeed a good question. I believe that the confusion lies in the fact that one definition of celiac disease is rather CIRCULAR. This definition makes the current diagnostic TOOL results equivalent to the disease.
Using this definition, you can't have the disease if the current tests aren't sensitive enough to pick it up.
Mars left you an excellent article in a link she put along with a copy of your post from here over on the General Message board. I hope it will become a permanent part of the information part of this site. Thanks Mars!
If you'll notice in that article, the standard that was used to judge the specificity and sensitivity of the current blood tests was arrived at by comparing them with the standard for diagnosing celiac disease, a positive small bowel biopsy. What if there were a way to detect a lesser degree of small bowel damage not picked up by the current method of biopsy? Would we then not see THAT used as the new standard for diagnosing celiac disease, and for that matter, defining it?
Already, some are advocating the gene test, and some positive blood tests with appropriate clinical observations of the patient are adequate in some cases to make a diagnosis, but I don't think that this is yet the rule by any means.
Also the stool tests are much more sensitive than the blood tests due to the antibodies being produced in the lumen of the gut, and thus being more prevalent in stool than in blood. This is evidenced by the fact that many who have negative blood tests, but are definitely sensitive to gluten have it show up on stool testing. Research has only been published in Italy verifying these test results, but in the USA,Dr. Fine's large study using the same general methodology of stool testing will hopefully be along soon.
This, in time, just may become a common method of detecting gluten sensitivity at a much earlier stage.
Dr. Fine's article should help to clear up the matter of the difference between gluten sensitivity and celiac disease. (See the links in the above posts, please.)
Guess for organizational purposes, for now, by definition, we'll just have to say that celiac disease is a common subset of a larger family of gluten sensitive conditions of which microscopic colitis is one. I think that the whole family of conditions will be reorganized according to what research produces in the coming years.
Generally, it seems as though these are multifactorial diseases as not everyone with the same genetic markers ends up getting the disease. In other words, something or some things have to trigger the gene/s. You'll learn of suspected culprets as you begin to explore this and Dr. Fine's site.
Alot is happening nowadays as far as celiac disease is concerned, and some of it may benefit M.C. sufferers. Have you read of the research of Dr. Al Fasano on zonulin blocker? This may help you to see the mechanism that may tie these gastrointestinal diseases together with a number of other autoimmune conditions.
I look forward to more stimulating questions. Thanks!
Yours, Luce
This is indeed a good question. I believe that the confusion lies in the fact that one definition of celiac disease is rather CIRCULAR. This definition makes the current diagnostic TOOL results equivalent to the disease.
Using this definition, you can't have the disease if the current tests aren't sensitive enough to pick it up.
Mars left you an excellent article in a link she put along with a copy of your post from here over on the General Message board. I hope it will become a permanent part of the information part of this site. Thanks Mars!
If you'll notice in that article, the standard that was used to judge the specificity and sensitivity of the current blood tests was arrived at by comparing them with the standard for diagnosing celiac disease, a positive small bowel biopsy. What if there were a way to detect a lesser degree of small bowel damage not picked up by the current method of biopsy? Would we then not see THAT used as the new standard for diagnosing celiac disease, and for that matter, defining it?
Already, some are advocating the gene test, and some positive blood tests with appropriate clinical observations of the patient are adequate in some cases to make a diagnosis, but I don't think that this is yet the rule by any means.
Also the stool tests are much more sensitive than the blood tests due to the antibodies being produced in the lumen of the gut, and thus being more prevalent in stool than in blood. This is evidenced by the fact that many who have negative blood tests, but are definitely sensitive to gluten have it show up on stool testing. Research has only been published in Italy verifying these test results, but in the USA,Dr. Fine's large study using the same general methodology of stool testing will hopefully be along soon.
This, in time, just may become a common method of detecting gluten sensitivity at a much earlier stage.
Dr. Fine's article should help to clear up the matter of the difference between gluten sensitivity and celiac disease. (See the links in the above posts, please.)
Guess for organizational purposes, for now, by definition, we'll just have to say that celiac disease is a common subset of a larger family of gluten sensitive conditions of which microscopic colitis is one. I think that the whole family of conditions will be reorganized according to what research produces in the coming years.
Generally, it seems as though these are multifactorial diseases as not everyone with the same genetic markers ends up getting the disease. In other words, something or some things have to trigger the gene/s. You'll learn of suspected culprets as you begin to explore this and Dr. Fine's site.
Alot is happening nowadays as far as celiac disease is concerned, and some of it may benefit M.C. sufferers. Have you read of the research of Dr. Al Fasano on zonulin blocker? This may help you to see the mechanism that may tie these gastrointestinal diseases together with a number of other autoimmune conditions.
I look forward to more stimulating questions. Thanks!
Yours, Luce