<<Disclaimer:  Verify this information before applying it to your situation.>>

[log in to unmask] wrote:

>Last Saturday, Dr. Alessio Fasano M.D. spoke to the Celiac Disease Foundation
>
>He indicated that
>the great American Medical community is probably 30 years ahead of the world
>in all areas except Celiac Disease. He feels we are 30 years behind, just
>because of poor diagnosis.

One thing the celiac aware doctors could do, is to encourage publications
like the popular Merck manual to suggest considering CD in appropriate
places. Elsewhere in Bory's recounting of Dr. Fasano's speech he mentioned
mouth ulcers as a CD symptom. So I looked it up. It said "Etiology is
unknown, but several factors point toward a localized immune reaction.
Deficiencies of iron, vitamin B12 and folic acid increase susceptibility.
Stress and local trauma are usually the predominant precipitating factors."
Nothing mentioned about CD, so I looked up the three deficiencies.

Under iron anemia etiology it says "The primary mechanism for Fe deficiency,
the most common cause of anemia, must always be considered to be blood loss;
in adults this is virtually the only possible mechanism."  Under "Other
bases for anemia may be..." it does mention "upper small-bowel malabsorption
syndromes".

Under vitamin B12 (pernicious anemia), after a long list of other things, it
says "Less common causes of decreased B12 absorption include ...
malabsorption syndromes ...". It does refer to chart 93-6 where CD and sprue
are listed in the Inadequate Absorption section.

On to Folic Acid. Here we get best billing and the author clearly links
malabsorption to the atrophy of the intestinal mucosa and the chart says
"esp. celiac disease, sprue".

Considering the numerous and varied symptoms of CD, there are many places
where the manual could suggest considering CD. The next edition will be
coming out in 1997 and will have dozens of contributing authors. Could
pointing out the places to them be a project for the MDs on this list?

The Merck manual is $30 ($24 at Barnes & Knoble) and has 2800 pages.
Hopefully the editors are independent and are not influenced by the
pharmaceutical ownership that may prefer "treatments" to "cures".

Don <[log in to unmask]>