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Examples of macroscopic features of villous atrophy detected by wireless capsule endoscopy in coeliac disease: A) Normal villi, B) scalloping of the mucosa on circular folds, C) fissuring of the mucosa, D) mosaic pattern. © Mayo Clinic

Researchers from the USA, Europe and other research centres are suggesting that Coeliac Disease has increased up to 4 x in the last 30 years.

They suggest that as much as 1% of the adult and child populations may have CD, and as we know there are many others that have yet to have the disease diagnosed, but experience problems with gluten and are diagnosed as being intolerant or sensitive.

Let’s be clear about what gluten intolerance is. ‘It isn’t a food allergy’. It’s a physical condition in your gut. Basically, undigested gluten proteins (prevalent in wheat and other grains) lurk around your intestines and are regarded by your body as a foreign invader, irritating your gut and flattening the essential microvilli along the small intestine wall. This reduces the surface area available to absorb the nutrients from your food. This can result in symptoms of malabsorption, including chronic fatigue, neurological disorders, nutrient deficiencies, anaemia, nausea, skin rashes, depression, and more.

Whilst there are better screening techniques today than there were in the 1980’s, we must also recognise that there are many other factors at work here, one of which is the changing levels of gluten in grains from hybridisation techniques.

What is the Best Test for Coeliac Diagnosis?

Thursday, 06 May 2010 by | Comments: 1
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Coeliac disease is regarded as a common disorder, yet many clinicians miss the cardinal signs that indicate further investigation is warranted. Coeliac disease is becoming an increasingly recognised autoimmune enteropathy caused by a permanent intolerance to gluten. Once thought to be a rare disease of childhood characterised by diarrhoea, coeliac disease is actually a multisystemic disorder that occurs as a result of an immune response to ingested gluten in genetically predisposed individuals and includes non gastrointestinal symptoms such as depression.

So how can practitioners decide if their patient has wheat intolerance or is requiring strict gluten avoidance to reduce the risk of linked diseases.

A paper out in the Journal of The American Medical Association on May the 5th looks at a variety of papers published since 1947 until 2009 to determine the evolution of investigative tests and to see which was most accurate. Two principle mechanisms for valid confirmation were identified.[1]

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Gastroenterology journal coverCoeliac disease is an autoimmune disorder triggered by gluten, a protein in wheat, barley, rye and spelt. Currently, the only treatment available is the adoption of a lifelong gluten free diet, which is made particularly challenging due to the ubiquity of wheat in western diets. It is an excellent example of environmental challenge meeting gene susceptibility, and is a unique example of how exclusion of an environmental trigger can resolve the symptoms.

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