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A "bully" is also typically a name-caller. And I'd say
that our recent poster did enough of that to qualify for
the "big bully award."

To recap what I gathered from her post (below): If you are
against gluten challenges and share your reasons with
others, then you're a "bully" and a "belittler". And
someone who puts a child on a GF diet without a proper
medical diagnosis is a "narcissist" who "in fact barks up
the wrong tree". Finally, the poster suggests that such
people should "take chances with their own health and
eschew informed medical advice."

But since she posed the following question, "Why should
[the child] be subjected to this?" (namely, a gluten free
diet... because "it is VERY hard for kids to follow a gf
diet") ...here's my reply:

Someone who forces a child to endure a gluten challenge
needs to be asking him/herself that very question!

Especially since gluten challenges lead to inconclusive
test results much of the time, and irreversible damage
could be done in the process (ie. the child could spend
the rest of his/her life with multiple secondary food
sensitivities and/or organ damage ...horror stories
abound, I've read many through this listserv).

The poster worries that if improvement is noted on the
diet, it could lead to a missed diagnosis because many
ailments including "parasitic infestation" and "bacterial
infection" could unexplainably improve on a GF diet. Have
you ever heard of a medical doctor becoming paranoid that
he/she will miss some underlying ailment because the
patient - for whatever reason - began to improve?!

First of all, "parasitic infestation" and "bacterial
infection" are things that can be assessed - and medical
doctors typically rule these things out prior to pursuing
a celiac diagnosis. It takes an average of 10-12 years to
diagnose CD for a reason, after all. Because we're
constantly looking elsewhere first.

After all of the non-invasive tests (breath, blood, urine,
stool...) have been performed, and gluten intolerance is
still left as a possibility, here's what I'd do if it were
my child: take the child off of gluten, keep the diet
centered around non-allergenics (things that you know your
child is not allergic to) including rice, potato, corn and
soy for awhile. If he/she improves, wonderful! Whether the
child is "celiac" or not, you're doing something right.

Gradually reintroduce the secondary items (things we
likely lose tolerance to in the presence of gluten
intolerance) like milk, yeast, and fructose.

But no... our poster would have you believe that to do
this (in lieu of a gluten challenge) would be to play
doctor with your beloved. Instead you should listen to
your M.D.

Hey, it may be 10, 20, 30 years down the road but the
"real" doctors will eventually figure it all out and send
your child packing with a legitimate diagnosis (and if the
interim was long enough there'd likely be a nice long
negative prognosis to go along with it).

The gluten free diet (or low-gluten diet for the
non-celiac gluten intolerant folks out there) is much
farther from a death sentence than a gluten challenge is
...but that's just my opinion (take it or leave it).

Dr. Megan Tichy

------ In response to: ------

"Many different gi conditions will show improvement on a
gf diet, even things such as parasitic infestations or
bacterial infections. Apparently nobody is really sure why
this is so.  It could lead you to safely conclude you are
celiac and have "fixed" the problem with a gf diet, when
in fact you are barking up the wrong tree and need
treatment for something else.

  As an adult, if you want to take chances with your own
health and eschew informed medical advice, that is
certainly your choice.

  I think parents of children with gi symptoms are in a
different situation.

Gluten challenges may prove necessary to try to confirm a
diagnosis.  It is VERY hard for kids to follow a gf diet,
in spite of all our best efforts to help them.  Why should
they be subjected to this if they are in fact not celiac?

   And what if in our narcissitic certainty that we can
confirm the diagnosis ourselves we miss another condition
that needs medical attention?

  If something worked for you, terrific - but no need to
bully everybody else into doing it your way, or belittle
them if they choose a different direction.

Lynn"

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