<<Disclaimer:  Verify this information before applying it to your situation.>>
 
=========================    Medical Information
 
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.  CD Symposium Video:  This 2-hour video contains the following topics,
as presented at the 1994 World Congresses of Gastroenterology:
 
 Introduction and CD pathogenesis, Martin Kagnoff, MD
 
 Approaches to management of adolescents and teenagers with CD,  Marvin
   Ament,MD
 
 How to find a celiac:  new approaches for diagnosis, Chris Mulder, MD
 
 Latent CD, treating unresponsiveness and malignant complications, Michael
   Marsh, MD
 
 The GF diet:  facts, fantasy, and practical approaches, Elaine Hartsook,
   Ph.D.
 
The video is available for $15, including postage.  Write to CDF, 13251
Ventura Blvd., Suite 3, Studio City, CA 91604-1838. (5)
 
2.  The third biopsy and a challenge:  In 1990, the European Society for
Paediatric Gastroenterology & Nutrition deleted the requirement for a third
biopsy.  The current requirement is a biopsy, clinical response, and two
laboratory responses for confirmation.
 
3.  Medical Writings on CD:  "In the past 30 years, a little more than
6,000 papers have been published on Celiac Disease.  Of these, only 10
were published by scientists from the United States." (6)
 
4. Why Study CD?  Dr. Stephen James, while speaking at the Baltimore
conference, answers this question.  Since it is clear for the most part what
causes CD, and since a very good treatment exists [the GF diet], one might
ask why a substantial amount of effort should be devoted to the study of
this disease.  The reason is that CD is the best example of a disease in
which certain genetically susceptible individuals have a very specific type
of inflammatory response in the intestine in response to a well-defined
stimulus.  If all the details of the pathogenesis of CD can be determined,
it is likely that this information will be useful in understanding other
diseases such as food allergy, the inflammatory bowel diseases, autoimmune
diseases triggered by dietary components, and helicobacter pylori infection
(the major cause of ulcers).  In addition, a clear understanding of this
abnormal response might make it possible to better trigger immune responses
in the gastrointestinal tract when they are desirable, such as with
vaccination or immunotherapy for autoimmune diseases.
 
5.  Bone Mineral Content:
 
"in young celiac patients . . . to be significantly lower than in
nonceliacs, but after the celiac kids had been on a glutenfree diet a
little over a year, bone mineral content built up faster than in other
youngsters, as if to make up for lost time.  The authors write: "Our
data indicates that although osteoporosis complicates CD during childhood
and adolescence, glutenfree diet alone is able to remarkably improve bone
mineralization." [AJCN, Feb. 1993, 224-228].
 
5.  Damage Areas of the Gut:
 
"The spectrum of manifestations of celiac sprue is remarkably broad, but the
severity of disease generally correlates with the length of small intestine
that is damaged.  When most or all of the small-intestine mucosa is
involved, symptoms are severe and malabsorption is generalized.  In such
patients, a diagnosis of celiac sprue is usually considered.  When, on the
other hand, the mucosal lesion is limited to the duodenum and proximal
jejunum, overt gastrointestinal symptoms and steatorrhea may be absent.
In those patients, clinical malabsorption of only one or two substances,
notably iron and float, that normally are somewhat selectively by the
proximal intestine.  Arriving at the correct diagnosis in such cases may
be quite challenging." (7)
 
6.  Epidemiological Studies have been limited in the US.  A screening tests
for CD in general populations, testing blood from donors was recently
conducted.  "We bought 2,000 blood samples from the Red Cross, and used
antigliadin, antiendomysial, and human umbilical cord antibodies for
screening.  We picked up 8 celiacs in the 2,000 samples, all of them
American, which was a frequency of 1 in 250". (8) "This single study shows
that the prevelance of CD is closer to that of Europe, approximately 1 in
300, not the previously stated 1 in 12,000 in the US.  Additional studies
will be required before this information will be accepted." (9)
 
7.  Hives
 
"are due to the release of chemicals from cells called Mast Cells.  Anything
that causes the release of these chemicals from mast cells may cause hives.
A common cause of hives is an allergic reaction to medications such as
penicillin or sulfa.  Drugs, like narcotics, may directly cause mast cells
to release their chemicals.  These are also substances released from active
immune cells (antibodies and other substances) that can cause the mast
cells to release its chemicals.  .  . .
 
People with autoimmune disease have active immune cells which release
substances.  These substances react with the mast cells or stimulate
circulating chemicals which react with the mast cells.  The result is
hives.  Between 5% and 10% of people with autoimmune diseases have hives.
In fact, the palms and soles are not infrequent places for hives to pop up
in people with autoimmune diseases." (10)
 
8.  BREAKING THE VICIOUS CYCLE, Intestinal Health Through Diet, Diet for
Crohn's Disease, Ulcerative Colitis, Diverticulitis, Celiac Disease, Cystic
Fibrosis, & Chronic Diarrhea by Elaine Gottschall,B.A., M.Sc.  Ms. Gottshall
says that "in various conditions, a poorly functioning intestine can be
easily overwhelmed by the ingestion of carbohydrates which require numerous
digestive processes.  The result is an environment that supports overgrowth
of intestinal yeast and bacteria thus either initiating the chain of events
or perpetuating it. The purpose of the Specific Carbohydrate Diet is to
deprive the microbial world of the intestine of the food it needs to
overpopulate." . . .
 
This 'resource' is not an orthodox way of looking at digestive diseases.
For Irritable Bowel, this restrictive diet may work for some people, at least
temporarily.   The therapy described in this book is not medically accepted.
Celiacs can tolerate this diet for a while, but in longer terms, they may
run the risk of malnutrition and further complications because the diet is
not nutritionally balanced. And if you thought a gluten-free diet was
restrictive....! This diet will definitely not cure Celiac Disease. The
recipes printed seem to be fine for a gluten-free diet, although no mention
is given to the avoidance of distilled vinegar or alcohol.  Breaking the
Vicious Cycle is definitely not recommended for celiacs. (11)