<<Disclaimer: Verify this information before applying it to your situation.>> Some people have indicated that they are unsure of what an intestinal overgrowth is, so here's a (rough) definition. Ordinarily the human gut contains many bacteria some harmless, some beneficial. Under certain conditions, undesirable bacteria and/or yeast, etc. (which may ordinarily be present at low level or may be "newcomers") can achieve population densities large enough to "crowd" out the beneficial bacteria. This crowding out of the beneficial bacteria and overpopulation of the wrong bacteria can cause numerous problems: It can change the pH of the gut, the bacteria/yeast or whatever can produce toxins and/or problem causing metabolic byproducts (alcohols from yeast, siderophores (chemicals used by bacteria to remove iron from our system), etc. etc.). Symptoms can be unusual color and/or consistency and/or frequency of stool, excessive gas, bloating, abdominal pain, rumbling gut, loss of weight, malabsorption, etc. Sound familiar? It can cause symptoms very similar to what celiacs get from ingestion of gluten or other things to which they react. This is the basis for my concern - I suspect that some (but almost certainly not all) cases of "refractory" celiac are actually cases of intestinal overgrowths which are misinterpreted as being caused by exposure to grains, this misinterpretation preventing the proper and effective treatment (i.e.: antibiotics) from being administered. Different forms of intestinal overgrowth (overgrowths of different microorganisms) can cause reactions to foods OTHER than the foods than usually cause problems to celiacs. For example, yeast overgrowths can be activated/exacerbated by the ingestion of simple sugars (sugar, honey, jam, etc.), especially if in large amounts. If one is looking only for hidden sources of grains, such connections might be missed. It is easy for a celiac to fall into the trap of assuming that anything intestinal is a result of celiac disease. But we, like everyone else, also occasionally get food poisoning, intestinal parasites, and all of the common ailments. Because of the necessity of being constantly on our guard about grains and forever looking out for reactions to hidden grains, it is all too easy to forget that. But the very important distinction is that intestinal overgrowths, unlike celiac, can be treated with antibiotics. Perhaps what we really need is some simple way of determining when something is NOT a celiac reaction, but an overgrowth. Maybe making it a practice of getting a blood panel done when we get intestinal symptoms of certain combinations (to be outlined by the experts) and we have had no known exposure to grains. What I am hoping to accomplish with the survey is to get some rough indication of whether or not this is a problem. If it looks like it might be, a more systematic and accurate survey would be in order. Jim Barron Chapel Hill NC [log in to unmask]