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

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Medical Information~Medical Information~Medical Information~
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Much medical information  is of no  interest to celiacs,  but articles are  a
simple way to explain an issue to a medical professional.  These extracts are
handy references  to show  your physician,  in his  technical language,  what
research has been  documented throughout  the world.   When  you encounter  a
similar problem, or, if you have a physician willing to learn from a patient,
share these articles for the benefit of all concerned.

1.  Initial Assessment and Follow-up Care of Celiac Patients by Peter Green,
M.D.

   [The summary of Dr. Green's talk has been removed here, because it]
   [already appears elsewhere in the archives--See CELIAC LOG9610E   ]

2.  Free Information from registered Dietitians is available by calling
(800) 366-1655.  They may not be experts in the GF diet.  This is an
excellent source on general nutrition.

3.  IMMCO Diagnostics is one of the four US companies with an excellent
understanding of the requirements for conducting serological diagnosis of CD.
They may be contacted for specimen collection kits: IMMCO Diagnostic, 963
Kenmore Ave., Buffalo, NY 14223, (800) 537-TEST, e-mail [log in to unmask]

4.  Bacterial Overgrowth:  Dr Betty Wedman is a celiac and nutritionist in St
Petersburg.  She recently made a reference to the fact that six of her seven
celiacs had bacterial overgrowth in the small intestines.  Therefore, it
would be prudent for celiacs to consider this possibility if they have
symptoms like abdominal cramps, bloating, gas, diarrhea, weight loss, and
Vitamin B12 malabsorption.

5.  Bone Density has always been a critical problem associated with women.
It is a problem that affects all celiacs according to Dr Elliott Schwartz,
Director, Foundation for Osteoporosis.

A recent issue of Gluten-Free Living  has a comprehensive article: "A
Practical Look at Celiac Bones" for those desiring an in-depth discussion
on celiac and bone problems.  Subscriptions available by writing to: PO Box
105, Hastings-on-Hudson, NY 10706 for $29.00.  One of the keys for living with
this problem is identification of the condition.  For this reason, the
following information can be used to convince your physician of the
requirements of a bone density test.  Since celiac is a GI related condition,
the indicators associated with the intestinal track are excellent reasons for
investigating the current status of your bones.

   Osteoporosis is now felt to be both preventable and treatable; but to
   apply the present strategies bone density testing is invaluable.
   Studies have show that clinical risk factors, such as thinness, blonde
   hair, blue eyes are not discriminating enough in individual patients to
   enable one to prescribe medication.  However, bone density testing is a
   very precise way to predict the risk of fractures while an x-ray is
   used to diagnose a current acute fracture.  This is comparable to using
   a cholesterol test to predict the risk of future heart attack and an
   ECG to diagnose an acute event.  In the same way that treatment is
   applied to lower cholesterol to prevent future heart attack, so
   treatment to prevent loss of bone should now be applied to prevent
   future fracture. (1)

The National Osteoporosis Foundation suggest four indications for tests: (2)

   (1) estrogen deficiency (e.g., menopause, primary and secondary;
   amenorrhea, such as from eating disorders)
   (2) vertebral abnormalities and radiographic osteopenia
   (3) long term glucocorticoid therapy
   (4) primary asymptomatic hyperparathyrodism

Other indications can include:

   (1) monitoring response to treatment
   (2) early glucorticoid therapy
   (3) renal disease
   (4) onset of first fracture as adult over 50 years of age
   (5) states of secondary hyperparathyrodism
   (6) disease causing malabsorption
   (7) treatment with medications known to cause bone disease, e.g.
   chemotherapy, thyroid
   (8) patients at risk for rapid bone loss of any cause
   (9) multiple risk factors. e.g. small, thin frame, family history of
   osteoporosis, smoking, excessive alcohol

Insurance reimbursement is a critical question to consider:

   On January 1, 1994, a national CPT code (76075) was adopted for bone
   density testing and Medicare began to formally pay for these tests. . .
   . Thus, all patients with some form of insurance should be covered
   completely or in part.  Some insurances may require preauthorization or
   have other restrictions. (3)

6.  Ask-A-Nurse allows registered nurses to provide general non emergency
information by phone.  The program is available at many local hospitals.
there is now a toll-free number, (800) 535-1111, for finding the phone number
of a local Ask-A-Nurse program.