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Tuesday
Jan032012

Interview w/ Dr. Alessio Fasano Part 3: Gluten Sensitivity (a new "food allergy")

Let's Review

THERE ARE 3 FORMS OF GLUTEN-BASED REACTIONS:   Celiac Disease, Gluten Sensitivity, and a Gluten/Wheat Allergy.  There are four different types of wheat allergy -- and each type behaves differently.

In Part 1 of this interview series, I was most privileged to speak with Dr. Fasano about gluten, our bodies’ response(s) to it, wheat allergies, and why so many people today have problems with wheat (plus rye, barley, spelt, triticale, etc.) and gluten-based products.  I learned a surprising fact:  no one can properly digest gluten. Read more...

In Part 2, we discussed testing for celiac disease.  Celiac Disease is a severe auto-immune disease triggered by the gluten protein.  Dr. Fasano and his team put together information on how to get tested for celiac disease.     According to Dr. Fasano the latest research shows that you need to have 4 out of the first 5 of the following markers in order to be diagnosed with Celiac Disease.  Read how to get tested...

 

Gluten Sensitivity - The New Kid on the Block

In this post, Part 3, Dr. Fasano's team answered questions about what Dr. Fasano calls "the new kid on the block", or... gluten sensitivity.  My thanks to Dr. Fasano and his team at the Center For Celiac Research.

 

TF: What is gluten sensitivity?

Dr. Fasano: As the word “sensitive” suggests, gluten sensitivity is a reaction to ingesting gluten, which is found in wheat, barley and rye. Symptoms can arise throughout the body and range from fatigue and “foggy mind” to diarrhea, depression and joint pain (see more on symptoms below).


TF: How does gluten sensitivity differ from celiac disease?

Dr. Fasano:  Although symptoms (particularly gastrointestinal) are often similar to those of celiac disease, the overall clinical picture is less severe. Recent research at the University of Maryland Center for Celiac Research shows that gluten sensitivity is a different clinical entity that does not result in the intestinal inflammation that leads to a flattening of the villi of the small intestine that characterizes celiac disease. The development of tissue transglutaminase (tTG) autoantibodies, used to diagnose celiac disease, is not present in gluten sensitivity.

A different immune mechanism, the innate immune response, comes into play in reactions of gluten sensitivity, as opposed to the long-term adaptive immune response that arises in celiac disease. Researchers believe that gluten sensitive reactions do not engender the same long-term damage to the intestine that untreated celiac disease can cause.


TF:  What are the symptoms of gluten sensitivity?

Dr. Fasano:  Just as in celiac disease, gluten sensitivity can affect all body systems and generate a wide variety of symptoms. Gastrointestinal symptoms can include diarrhea, bloating, cramping, abdominal pain and constipation. Behavioral symptoms can include “foggy mind,” depression and ADHD-like behavior. Other symptoms include anemia, joint pain, osteoporosis, and leg numbness.


TF: How many people does gluten sensitivity affect?

Dr. Fasano:  Research from the University of Maryland Center for Celiac Research indicates that it affects approximately 18 million people, or six percent of the population.


TF:  How can I tell if I have gluten sensitivity and what should I do?

Dr. Fasano: This is something to discuss with your family physician or health care provider. If celiac disease and other conditions have been ruled out, i.e., irritable bowel syndrome and other forms of intestinal inflammation, talk to your doctor and dietitian about a gluten-free diet. Please do not undertake the gluten-free diet as treatment without the supervision of health care professionals as nutritional considerations as well as health considerations must be taken into account with this treatment.


TF:  Do I still need to be tested for celiac disease if I think I’m gluten sensitive?

Dr. Fasano:  Yes. You need to be tested for celiac disease to rule out the possibility of long-term complications. Accordingly, do not go on a gluten-free diet until the possibility of celiac disease has been eliminated through testing. If you go on a gluten-free diet and are then tested for celiac disease, the tests could be falsely negative due to the lack of autoantibodies in your blood serum.

Read how to get tested for celiac disease here.


TF:  Is there a test for gluten sensitivity?

Dr. Fasano:  Although researchers at the CFCR are working to develop tests for gluten sensitivity, currently there are no definitive blood tests for the condition.


TF:  Is there a cure for gluten sensitivity?

Dr. Fasano:  Just as in celiac disease, there is no cure for gluten sensitivity. The only treatment currently available is the gluten-free diet.

 

Other Articles on Gluten-based Reactions


Interview w/ Dr. Alessio Fasano Part 1:  Should Anyone Eat Gluten?

Interview w/ Dr. Alessio Fasano Part 2:  How to Get Tested for Celiac Disease.

 

About Dr. Fasano & the Center For Celiac Research

Alessio Fasano, M.D., is the director of the University of Maryland Center for Celiac Research, professor of pediatrics, medicine and physiology at the University of Maryland School of Medicine and director of the Mucosal Biology Research Center at the University of Maryland School of Medicine.  Dr. Fasano is an expert on gluten/wheat allergies and celiac disease.  In 2011, he led the research team who discovered a new immune reaction called "gluten sensitivity".

University of Maryland Center for Celiac Research is an institution engaged in clinical care, diagnostic support, education, and clinical and basic science research in Celiac Disease.

The paramount goal of the Center for Celiac Research is to increase the awareness of Celiac Disease in order to provide better care, better quality of life, and more adequate support for the Celiac Disease community.  To view the CFCR's brochure, CLICK HERE.

 

 


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  • Response
    Good an very informative post. I will come back to your blog regullary. One thing: I do not exactly know what do you mean in the second paragraph. Could you please exmplain your opinion?

Reader Comments (7)

It is my experience that those who have not complied with a strict diet are also those who imagine that the psychological rewards could offset the inconvenience of the diet. I’m sure there are isolated cases such as you suggest, but most such individuals would quickly be dissuaded by the many inconveniences associated with dietary avoidance.
April 1, 2012 | Unregistered Commentercolon help
Wow! One of the best on celiac I've ever read! Thank you! So helpful!,,
December 3, 2012 | Unregistered CommenterJulie Bradley
Thanks very much, Julie! I'm so glad it was helpful to you!
This blog has been very informative, however, after being diagnosed with celiac disease and following a strict gluten free diet for 25 years I continue to have severe symptoms on a regular basis. I have been unable to get help or any answers for my situation. Is it possible that the damage done to my bowel is beyond repair?
July 6, 2014 | Unregistered CommenterGloria Brady
Thanks for your comment, Gloria. I"m terribly sorry to hear that your symptoms are so stubborn. You are not alone. Dr. Fasano, in our most recent interview says this: "There are some people who don’t respond to a gluten-free diet. This is a condition called Refractory Sprue. Refractory Sprue is defined by a persistent or recurrent malabsorptive symptoms and villous atrophy despite strict adherence to a gluten-free diet*. These patients don't even have to ingest gluten in order to have a celiac-like reaction.

Here is a link to that interview: http://www.tenderfoodie.com/blog/2014/5/1/dr-fasano-on-new-gut-autoimmune-research-autism-clearing-up.html

There are certain diets that can help repair the small intestine, and also help calm the immune system so it stops reacting once the gut is healed. Dr. Fasano has one he has developed. There is also the GAPS Diet - especially the intro portion - that is quite healing (it heals and seals the gut w/ strict adherence). Personally, I've been on GAPS and highly recommend working with a knowledgeable GAPS practitioner to help you, if you try this route. There are nuances in the diet that can make a huge difference in how it affects you. Dr. Fasano has also had great success with his diet which is outlined in his book.

Something else to consider is that there could be infections (parasitic, bacterial, virus) that are loving a damaged gut, and keeping it from healing. GAPS and other diets help rid the gut of most of these, but sometimes there are several layers to the healing that need to be addressed.

There are other techniques / therapies out there that help stimulate the growth of new stem cells. I'll be writing about that at some point, as well. Stay tuned.


Does this help? If you haven't read the latest interview with him, see if this helps answer some of your questions. Wishing you the very best of success in your healing journey.
where can I get a copy of the Fasano diet
July 9, 2014 | Unregistered CommenterGloria Brady
Hi Gloria,

Thank you for your question! I checked with Dr. Fasano's team at the Center and they do not have a copy of the diet but work one on one with patients to implement the diet. There are specific reasons for this, and I'll get more information and post to the blog later as to why this is and how people can work with the Center or the diet. So stay tuned for more.

elisabeth

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