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Jefferson Adams posted an article in Anemia and Celiac DiseaseCeliac.com 10/17/2017 - Are primary care physicians under-testing for celiac disease in patients with iron deficiency anemia? A new survey of primary care doctors indicates that they are. It's fairly common for people with celiac disease to develop iron deficiency anemia (IDA), but researchers don't know much about the frequency with which primary care physicians test for celiac disease in patients with IDA. A team of researchers recently set out to describe how primary care doctors approach testing for celiac disease in asymptomatic patients with IDA. The research team included Marisa Spencer, Adrienne Lenhart, Jason Baker, Joseph Dickens, Arlene Weissman, Andrew J. Read, Seema Saini, and Sameer D. Saini. They are variously affiliated with the Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States of America; the Department of Internal Medicine, Henry Ford Health System, in Detroit, Michigan, United States of America; the Department of Statistics, University of Michigan, Ann Arbor, Michigan, United States of America; the Research Center at the American College of Physicians, in Philadelphia, Pennsylvania, United States of America; Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States of America, Ambulatory Care, Veterans Affairs Medical Center, Ann Arbor, Michigan, United States of America. For their study, the team began by electronically distributing a survey to primary care doctors who are members of the American College of Physicians. The survey asked whether doctors would test for celiac disease, either by serologic testing, referral for esophagogastroduodenoscopy [EGD], or referral to GI) in hypothetical patients with new IDA, including: (1) a young Caucasian man, (2) a premenopausal Caucasian woman, (3) an elderly Caucasian man, and (4) a young African American man. The team chose the scenarios to assess differences in testing for celiac disease based on age, gender, and race. They used multivariable logistic regression to identify independent predictors of testing. Testing for celiac disease varied significantly according to patient characteristics, with young Caucasian men being the most frequently tested (61% of respondents reporting they would perform serologic testing in this subgroup (p Interestingly 80% of doctors surveyed said they would definitely or probably start a patient with positive serologies for celiac disease on a gluten-free diet prior to confirmatory upper endoscopy, which is contrary to guideline recommendations. This survey indicates that primary care doctors are under-testing for celiac disease in patients with IDA, regardless of age, gender, race, or post-menopausal status. The majority of primary care doctors surveyed do not strictly adhere to established guidelines regarding a confirmatory duodenal biopsy in a patient with positive serology for celiac disease. Clearly, even with all of the advances in celiac disease awareness and with more refined protocols, primary care doctors have some work to do when it comes to testing IDA patients for celiac disease, and even more work to do in following proper referral guidelines before putting patients on a gluten-free diet. Source: PLOSONE
Jefferson Adams posted an article in Gluten-Free Food Ingredient Labeling RegulationsCeliac.com 03/18/2015 - A man who suffers from celiac disease has sued the FDA for allowing gluten to be used as a coating on prescription drug and over-the-counter medicine capsules. Remember, people with celiac disease can suffer intestinal damage when they consume gluten. This can damage can lead to neurological, among other disorders. The man, Michael Weber, was taking a generic drug seven years ago, and developed side effects consistent with ingesting gluten. Weber says he was unable to determine the drug’s gluten status through his pharmacist, and Weber went on to petition the FDA to either eliminate wheat gluten in medicines or require new labeling on drugs containing the protein. In 2011, the FDA sought public comments about the issue. In 2014, the FDA issued gluten-free definitions and labeling standards for commercial foods, but has failed to act on drugs. So Weber has now filed a lawsuit to demand the FDA do something. The complaint can be read here. This raises a couple of questions: Do people with celiac disease deserve to know if there is gluten in their medicine? Do they deserve access to medicines that are gluten-free? Should the FDA definitions and labeling standards also apply to drugs and medicines?
Celiac.com 04/12/2016 - A mainline Protestant pastor has not been found guilty of failing to serve gluten-free bread during communion and has not been defrocked for said indiscretion. An article credited to one Ligonberry Fields, described as a "Buzzvine Contributor," recently appeared on the Christianpost and stated that one Frankie Shaver was relieved of her duties as senior pastor of Cheap Grace United Methodist Church on Wednesday, after being found guilty by a tribunal headed by members of the Kansas-Alabama Board of Ordained Ministry (KA BOOM). The article included what appear to be numerous attempts at humor, many lost or muddled due to questionable syntax. Consider this description of "one UMCer, who requested anonymity and gender inclusive language when speaking to the press." Per the article: "The, um, clergyperson then went on to explained that at his – derp! – their church, they only pretend to serve gluten free bread by having a person holding what appears to be morsels of gluten-less communion." Or this quote, attributed to Allie Nobel, member of KA BOOM: "What the former pastor of CG UMC did was inexcusable and worse yet, might have alienated the people we are desperately trying our best to cave in to." The dead giveaway might have been the part that read: "KA BOOM's explosive news has sent a shock wave among UMC clergy, who before this assumed that the punishment for being caught without gluten free bread was, at worst, being forced to write a 5,000-word Adam Hamilton book review." Beyond the headline, I'm not sure how any of this is supposed to be funny, though I take it that the writer intended this simply as wry, politically incorrect humor directed at gluten-free communion supporters, rather than as any direct disparagement of gluten-free communion supporters, in general, "clergypersons" (sic) included. But, since the article was not serious, no actual pastors were defrocked for failing to serve gluten-free communion. Which is a good thing, I think. Read more at Christianpost.com.