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Good news for all of you who are anxious for advances in physician
education:
 
During Digestive Disease Week, a medical conference in San Francisco last
week, there was a symposium on Celiac
Disease. The brainchild of Dr. Martin Kagnoff and Elaine Monarch of the
Celiac Disease Foundation, this AGA Clinical Symposium featured Dr. Kagnoff
of UC San Diego; Dr. Paul Ciclitira of St. Thomas' Hospital in London,
England; and Dr. Michael March of Hope Hospital in Manchester, England. The
hall which seated at least 340 people was not big enough for the 400+
physicians who attended the session.
 
While much of the three presentations covered the testing, genetics,
peptide triggers, and intraepithelial changes pertinent to Celiac Disease,
the treatment and follow-up responsibilities of the physician were also
emphasized.
 
Also mentioned was the possible high numbers of asymptomatic celiacs and
the need to find them by testing first-degree relatives of celiacs. While
between 6% and 20% of first degree relatives are found to have flat villi,
one study cited noted that 50% of those celiac relatives experience NO
symptoms.
 
Another point relevant to celiacs themselves is that the predisposition to
malignacy in GLUTEN-EATING celiacs is high, and not just for lymphomas.
Other, more common forms of cancer were also noted as unusually high. (See
Stokes, B J Prev Soc Med 1976) (The mention of breast cancer got my
attention since it is too common in my female relatives.)
 
Dr. Marsh reminded his colleagues to do a celiac work-up on persons with
malignant carcinomas and lymphomas. (There is much to learn about silent
celiac disease if gastroenterologists look for antibodies and villi damage
in their cancer patients.) Then he discussed steroid treatment of celiacs
who respond slowly to the GF diet.
 
Even for a layperson, it was enlightening to hear British physicians speak
from their abundant clinical observations of Celiac Disease. For now, there
are no physicians in the US with such large celiac patient pools.
 
Celiac List contributor, Dr. Donald Kasarda was praised more than once
regarding his study of amino acid sequences in gliadin. Congratulations.
 
Mary Courtney
[log in to unmask]
Los Angeles