Do you suffer from symptoms of abdominal pain, stomaches, excess bloating, gas, diarrhea, fatigue, bone or joint pain, skin rashes, headaches, difficulty concentrating or irritability? Gluten, the major protein in flour made from wheat, causes many people such symptoms yet most are unaware of the cause and that the cure is available in a gluten-free diet. Though there are diagnostic tests available there are limitations to these tests. Moreover, many physicians are unaware of the broad manifestations of gluten sensitivity and fail to order tests that could discover the cause. The beauty of this condition is that once it is diagnosed and gluten free diet started the symptoms are usually reversible.

Worldwide nearly 1 in 100 people have the most severe form of gluten sensitivity known as Celiac disease (CD) though it estimated that more than 90% are undiagnosed. Startlingly, many more than this, possibly 10-30% of people of Northern European ancestry, have lesser forms of gluten sensitivity resulting in symptoms that improve on a gluten free diet. The popularity of low carbohydrate diets has not only been the weight loss many people experience but dramatic health improvements reported such as increased energy, relief of fibromyalgia, joint aches, improved skin, fewer headaches, and improved digestive symptoms. However, many people fail to gain full benefit because they are unknowlingly gluten sensitive and do not completely eliminate gluten from their diet.

Gluten being insulinogenic, meaning it stimulates insulin release, and thereby promotes weight gain. Abnormal blood sugar regulation may occur. In fact, it is now known that more than 10% of insulin dependent diabetics have Celiac disease. What is not yet known is whether the Celiac came first or the diabetes but they occur commonly together. CD is also commonly associated with other autoimmune conditions such as lupus, rheumatoid arthritis and thyroid problems. CD is a reveersible cause of infertility, low birth weight infants, pre-term labor and recurrent miscarriages. Untreated it is associated with a significant increase risk of numerous cancers including all GI cancers and lymphoma. It is common cause of unexplained iron deficiency and causes osteoporosis prematurely. Dietary elimination of gluten allows the intestine to heal so that absorption is normalized, symptoms are relieved, and after five years of gluten-free diet the cancer risk returns to normal as long as the individual remains gluten-free for life.

Classic Celiac disease is diagnosed by abnormal blood tests and an abnormal appearing intestinal on biopsy but lesser forms of gluten intolerance may be missed when these tests are normal or borderline. Stool antibody testing for gluten related antibodies has been performed in research labs and published in a few studies. A commercial lab, Enterolab, now offers these tests but the research gastroenterologist who patented the test has yet to publish the results of his findings in a peer reviewed journal though data and clinical experience by some of us have indicated the tests are very sensitive for Celiac as well as gluten sensitivity not of the degree to cause abnormal blood tests or biopsies but symptoms that reverse on a gluten-free diet instituted by those with abnormal levels.

Blood tests for Celiac disease include antibody tests for gliadin (AGA), the toxic fraction of gluten; endomysial antibodies (EMA); and tissue transglutaminase sntibody (tTG). High antibody levels to EMA and tTG are generally accepted as diagnostic for Celiac disease though some individuals with Celiac and most with lesser degrees of gluten sensitivity may have normal levels. AGA levels have in the past been considered very sensitive but not specific for Celiac disease. Newer assays for AGA antibodies may be as or more accurate than EMA and tTG antibody tests.

Small intestine tissue obtained by biopsy during upper gastrointestinal endoscopy has been considered the “gold standard” for the diagnosis of Celiac disease. Recent studies demonstrating that some people with gluten sensitivity and relatives of Celiac may have changes on small intestine biopsy that can only be seen with special stains not routinely employed. The first known as immunohistochemistry stains can detect increase white blood cells called lymphocytes in the intestine lining as the earliest sign of gluten induced injury or irritation. Electron microscopy, available only as a research tool, has also shown very early ultrastructural changes in some individuals when all other tests are normal. When people with such findings are notified of these changes and offered the option to start a gluten-free diet they have usually responded favorably according to the research articles published. Many of those who continued to eat gluten and were followed up with repeat testing developed classic Celiac disease.

What these studies suggest is that a “normal small intestine biopsy” may exclude Celiac disease as defined by strict criteria it does not exclude gluten sensitivity. This has been the experience of numerous individuals and many physicians who appreciate the concept of the spectrum of gluten intolerance or sensitivity. Most traditional sources of information on Celiac disease and physicians either unfamiliar with the research on Celiac or who are holding onto the strict criteria for Celiac being the only indication for recommending a gluten free diet leave many gluten sensitive individuals confused or frustrated. Some get their diagnosis missed, are misinformed or receive incomplete information. As a result they may fail to benefit from the health benefits of a gluten-free diet because they are advised that it is not required because they have normal blood tests and/or normal biopsies.

Another source of confusion lies in the knowledge that certain genetic patterns are present in over 90% of individuals with Celiac disease. Testing for such specific blood type patterns on white blood cells known as HLA DQ2 and DQ8 is increasingly be employed to determine if a person carries the gene pattern predisposing to Celiac disease. Some use the absence of these two patterns as a way of excluding the possibility of Celiac disease and the need for testing or gluten-free diet. However, there are rare reports of classic Celiacs who are DQ2 and DQ8 negative. Moreover, recent studies indicate other DQ patterns may be associated with gluten sensitivity though very unlikely to predispose to classic Celiac disease.

Testing for all the DQ patterns has been advocated by Dr. Ken Fine, a research gastroenterologist from Baylor School of Medicine who founded the commercial lab Enterolab to offer his patented stool testing for gliadin antibodies and tissue transglutaminase antibodies as well as several other stool tests for food intolerance or colitis. Though not widely accepted, these tests have gained favor in the lay public’s opinion as an option for determining if they are sensitive to gluten or other food proteins either despite of negative blood tests and or biopsies or in place of these more invasive tests. The favorable reports in the lay community has been overwhelmingly positive though can't be subjective to peer review by the medical community prior to the publication of Dr. Fine's data. Physicians open to the broader problem of gluten sensitivity are reporting these tests helpful in many patients though some are not certain how to interpret the tests and the Celiac organizations have difficulty commenting on their application short of published research. Dr. Fine's unpublished data indicate those with abnormal stool tests indicating gluten sensitivity overwhelmingly respond favorably to a gluten free diet with improvement of symptoms and general quality of life.

More details about the genetic and stool testing can be found in other articles published by this physician as well as Enterolab's website www.enterolab.com. (http://ezinearticles.com/?expert=Dr._Scot_Lewey) and in the references included in my article http://ezinearticles.com/?Celiac-Disease-Versus-Gluten-Sensitivity:
-New-Role-for-Genetic-Testing-and-Fecal-Antibody-Testing?&id=208578

Various Celiac educational websites exist including http://www.celiacscsa.org and http://www.celiac.com but are sometimes confusing to people who realize they don't fit the strict criteria for Celiac disease but know they are gluten sensitive because of the dramatic improvement they note with gluten-free diet. Those interested in more information on non-Celiac gluten intolerance and other food intolerances may sign up for future updates from the forthcoming premier website www.thefooddoc.com by submitting an e-mail to thefooddoc@mac.com.

Dr. Scot Lewey is a physician who is trained and board certified in the specialty of gastroenterology (diseases of the digestive tract) and has a growing practice focused in the area of food intolerances, especially gluten and cow's milk protein. He is a published researcher and author and founder of an educational website http://www.thefooddoc.com dedicated to helping people with food intolerances.

Article Source: http://EzineArticles.com/?expert=Dr._Scot_Lewey