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Dear Mr and Mrs. Kennedy,
I red your e-mail concerning the frustration about the resistance of
doctors to "try a gluten free diet".  It is out of discussion that there
are many phisicians (including gastroenterologists) that are poorly
knowdlegible about celiac disease and their advises may sometimes
generate confusion.  But it is also out of discussion that there are
outstanding experts on the disease that spent a great deal
of time and effort to come out with reccomendations and guidelines for
the correct diagnosis of the disease.  When you state: "..it IS possible
to just try the diet rather then put kids.. thru the biopsy", you
contribute to generate this confusion.  As you well know, Celiac disease
is a life-long condition (in other words, when you got, you got it!).
You cannot commit yourself for the rest of your life to a challenging
diet without being 100% sure of the diagnosis.  Currently, there are no
short cuts:  testing for the antigliadin and antiendomysium antibodies,
followed by the intestinal biopsy (if the antibodies are positive) is the
ONLY way to make the diagnosis.  Trying a diet, without being sure of the
diagnosis, is like treating yourself as a "guinea pig".  If we really want to
avoid that other patients will experience the same frustrations that you and
other people had suffered, we should work togheter to educate the american
scientific community and the next generation of physicians to learn
about the disease.  We are working very hard on this task as well as to
prove that celiac disease is not a negligible condition in USA.

Alessio Fasano, M.D., Director
Division of Pediatric Gastroenterology and Nutrition
University of Maryland, School of Medicine
Baltimore,MD
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