Do You Have Celiac Disease and Have Questions Or Need Help?
Join Celiac.com's forum / message board and get your questions answered! Our forum has nearly 1 MILLION POSTS, and over 62,000 MEMBERS just waiting to help you with any questions about celiac disease and the gluten-free diet. We'll see you there!
Follow / Share
|Get Email Alerts|
- Safe Gluten-Free Food List (Safe Ingredients)
- Unsafe Gluten-Free Food List (Unsafe Ingredients)
- Gluten-Free Alcoholic Beverages
- Celiac Disease Symptoms
- The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free
- Interpretation of Celiac Disease Blood Test Results
- Is Buckwheat Flour Really Gluten-Free?
The ‘Masking’ of Celiac: Do Not Ignore the Smoking Gun
- By Dr. Rodney Ford M.D.
- Published 01/2/2015
- Celiac Disease Diagnosis, Testing & Treatment , Journal of Gluten Sensitivity Autumn 2014 Issue
Dr. Rodney Ford M.D.
Dr. Rodney Ford is a Pediatric Gastroenterologist. He was Professor of Pediatrics at the Christchurch School of Medicine. He runs the Children's Gastroenterology and Allergy Clinic in New Zealand. He has written a series of 7 books on gluten (www.DrRodneyFord.com). His main theory is that symptoms from gluten reactions arise from brain and nerve damage. His latest book is "The Gluten Syndrome" which encapsulates current ideas and concepts of gluten and the harm that it does.View all articles by Dr. Rodney Ford M.D.
This article originally appeared in the Autumn 2014 edition of Celiac.com's Journal of Gluten-Sensitivity.
Celiac.com 01/02/2015 - What an odd thing to say: “Do not mask the appearance of celiac disease.” Inferring that you keep on eating gluten, despite early signs of celiac disease, until you get enough damage to your intestines that it can be seen under a microscope. I totally disagree with this concept—but this is still a common belief of medical practitioners.
For instance a dietitian said this recently: “Gluten-free diet as an experiment to see if you (or your children) feel better, can be beneficial, but this approach can mask underlying celiac disease.”
Have you ever heard of a doctor “masking” the diagnosis of heart disease by failing to treat high blood pressure or high cholesterol until the patient has a heart attack? Ridiculous! Have you ever heard of a doctor “masking” the diagnosis of depression so that the person is suicidal before given help? Ridiculous!
A colleagues writes: “As far as ‘masking’ celiac disease, that would be like saying that a person who is pre-diabetic should continue to eat lots of sugar and carbs so they can destroy enough beta cells to develop full blown diabetes. That eating low carb might mask diabetes. Meanwhile the pre-diabetic blood sugars can continue to damage the body in many insidious ways. Maybe these dietary changes should be looked at as preventive measures that are good.”
So why is the “masking” concept reserved for celiac disease? I regard a slightly raised tTG result as a ‘smoking gun’ (this also goes for EMA and DGP). Yes, the concept of “do not go gluten-free so that you do not mask celiac disease diagnosis” is contentious.
There are many threads to this problem:
- Celiac disease is a progressive condition—it slowly gets worse the longer you eat gluten;
- In the early stages of CD, it cannot be diagnosed by endoscopy biopsy;
- The biopsy test is inaccurate and relies on experts to recognize early disease;
- Most people who get gluten-illness do not have celiac disease;
- Gluten-related-disorders-without-gut-damage are indistinguishable from early-celiac-without-gut-damaage-yet;
- Carrying the HLA DQ2/DQ8 gene cannot be used to make a diagnosis, but if you do not carry the gene, it will be very unlikely that you have celiac disease;
- The “masking” concept originated a few decades ago when biopsy was the only way to diagnose celiac disease;
- Now, the blood tests for celiac disease (EMA, tTG, DGP) are more accurate than the biopsy, and can turn positive BEFORE there is any histologic evidence of gut damage;
- Once celiac disease has become established, you cannot guarantee complete remission;
- Gluten challenge is detrimental to your health;
- A gluten challenge (to create serious bowel damage) can take years, during which time ongoing body damage (brain, skin and bowel) is ongoing;
- Celiac disease and gluten-senitivity often co-exist.
This concept is addressed in my new book “Gluten-related disorder: sick? tired? grumpy?” Available as an ebook at http://www.GlutenRelatedDisorder.com.
Celiac.com welcomes your comments below (registration is NOT required).
Irritable Bowel Syndrome Could Be Tied to Gluten Issues
Celiac disease research is linking Irritable Bowel Syndrome with gluten intolerance and doctors are recommending IBS sufferers, especially those with diarrhea-predominant IBS, to get tested for gluten issues or celiac disease.... [READ MORE]
New Insights into Inflammatory Bowel Disease Serology Testing
Specialty pharmaceutical and diagnostic company, Prometheus Laboratories Inc.... [READ MORE]
Lesser Degrees of Villous Atrophy Correspond to a Greater Frequency of Seronegative Celiac Disease
A recent study published in
the journal Digestive Diseases and Sciences indicates that lesser degrees
of villous atrophy correspond to seronegative celiac disease.... [READ MORE]
Duodenal Histology in Patients with Celiac Disease after Treatment with a Gluten-free Diet
This new study
emphasizes the importance of following a strict gluten-free diet, and
getting regular follow-up biopsies after your diagnosis.... [READ MORE]
New Intestinal Permeability Test Kit Approved
Diagnostic Laboratory (GSDL), a private, rapid-growth Functional Medicine
Clinical laboratory, announced today receipt of 510(K) market clearance
from the Food and Drug Administration (FDA) for its Intestinal Permeability
test kit, utilizing the lactulose-mannitol challenge drink.... [READ MORE]