Testing for celiac disease before starting a gluten free diet. If you like this article, please follow me on Facebook, Instagram or Twitter for similar information. Blog coming February 2. Six Reasons To Test For Celiac Disease Before Starting A Gluten- Free Diet. Many people ask me “ Why can’t I just start a gluten- free diet and see if I feel better? Why do I need to spend the money on testing? I just won’t eat gluten if it makes me feel sick.” I hope that the following points clarify why appropriate testing for celiac disease is important before starting a gluten- free diet or putting your child on one. I cannot stress enough the importance of testing for celiac disease. The screening is simple and inexpensive. The cost of not testing is much greater. You feel better! If you have non- celiac gluten sensitivity (NCGS) and you stop eating gluten, what happens? You feel better! You can’t tell the difference between these two entities without testing. If you eliminate gluten before testing for celiac disease- the celiac tests are invalid. Why is that important? We don’t understand a lot about NCGS yet, but so far it appears to be different from celiac disease in important ways. The celiac tests don’t find it, and the biopsy doesn’t show it. They are not the same disease. Some people get very sick eating gluten and they don’t have celiac disease. But, contrary to Internet lore, there is no scientifically proven way to diagnose NCGS with a lab test. NCGS can only be diagnosed through an elimination diet. First, you rule out celiac disease (“ruling out” or “excluding” means testing for it to confirm you do not have it). If the results are negative, you can eliminate all gluten from your diet, including sources of cross- contamination. If a gluten- free diet resolves your symptoms, you and your doctor may conclude you have non- celiac gluten sensitivity. NCGS is evolving into an “umbrella diagnosis” meaning it is syndrome that may be be caused by several different things such as fructose malabsorption or ATI intolerance. Having a celiac test is the first step in appropriately diagnosing NCGS. If you have it, there is a chance your children have it or will develop it later. If you have celiac disease, but do not get it diagnosed and just assume it is non- celiac gluten sensitivity, your whole family can be impacted by this choice. The family needs to know. It is recommended that all first- degree relatives (siblings, children, parents) of anyone diagnosed with celiac disease should be screened for celiac disease, whether or not they are aware of any symptoms. Symptomatic second- degree relatives (aunts, uncles, cousins, nieces and nephews) should also be screened. However, I know family screening doesn’t always automatically happen. If you have a formal diagnosis of celiac disease yourself, it should prompt the pediatrician to test your child for celiac disease as a possible cause of your child’s symptoms. If the doctor doesn’t suggest testing, you can request it. If you have started yourself on a gluten- free diet without testing, you have put yourself in the non- celiac gluten sensitivity category and your child’s doctor is much less likely to test your child for celiac disease. Silent celiac disease. Even if your kids do not appear to have symptoms, they could have silent (asymptomatic) celiac disease. People with silent celiac disease are not aware of any symptoms, but damage is being done internally. The key to long- term health with celiac disease is early diagnosis and treatment. If you don’t test yourself for your own sake, do it for your children’s sake. Whether they exhibit symptoms or not, the damage is happening. We DO know how careful people with celiac disease have to be with cross- contamination. We DON’T know how careful non- celiac gluten sensitivity patients need to be. In my experience, most gluten- sensitive patients are not as careful as celiac patients. Does the fact that they have NCGS allow them to be more liberal? Scientifically speaking, we just don’t know. At this point, I err on the side of caution and recommend that NCGS patients be just as careful as those with celiac disease. Know your risk by getting diagnosed. What if you have celiac disease, but are not aware of it? Perhaps you think you are “just gluten sensitive” so you have a little here and there or are less careful about cross- contamination. Would these small amounts of gluten put you at risk for complications? If you have celiac disease, the answer is yes. Even if you do not have external symptoms from small amounts of gluten — some do not — the damage is happening and the increased health risks are stacking up. Save your health and your money by knowing the difference. Valid screening tests for adults are the blood tests t. Celiac Disease Symptoms (from Those Living with the Disease): An Infographic. Many restaurants have started to accommodate gluten-free (gf) requests for those with celiac disease and gluten sensitivity. Currently, about one percent of the. TG- Ig. A (tissue transglutaminase) and total serum Ig. A, done together. There currently is no scientific data supporting stool testing or gluten sensitivity testing. If an online lab is promising to diagnose gluten sensitivity, the test it is offering is not recommended as valid or medically useful by celiac experts such as Dr. Peter Green, Dr. Stefano Guandalini or Dr. Alessio Fasano, and it is unlikely to be reimbursed by insurance. Do the appropriate, valid celiac testing before starting a gluten- free diet and skip the “scientific- looking” lab websites offering unvalidated tests. If you have ruled out celiac disease, you can then eliminate gluten from your diet (for free!) and see if your symptoms resolve. Save on health care. Health care is expensive. Wouldn’t you like to get more of it reimbursed? Insurance is more likely to pay for the portion of your health care related to celiac disease if you have a formal diagnosis. Currently, there is no insurance code for gluten sensitivity, so reimbursement is challenging at times. Don’t buy gluten- free if you don’t need to. Gluten- free food is expensive. If you don’t need it, why buy it? I have seen many patients in my office on a gluten- free diet because someone told them to start it for whatever their particular ailment is. They haven’t noticed any changes in their health, yet they continue to follow the diet. Do they need to? If we rule out celiac disease, and they don’t have symptoms of gluten sensitivity, going back to a balanced gluten- containing whole food diet may be a huge help to their budget. YOU DESERVE ACCOMODATIONSDiagnosis is necessary for ADA accommodation. Given the recent settlement between Lesley University and the Department of Justice, schools may soon be legally required to accommodate students with documented food allergies and celiac disease in dormitories and cafeterias. A requirement to accommodate special dietary needs for these students will fall under the umbrella of the Americans with Disabilities Act. In order to obtain ADA accommodations, students will need signed documentation from a licensed physician stating they have a diagnosis of celiac disease or food allergies. Get it done while you can. If your child has celiac disease, but no diagnosis, it is unlikely they will be eligible to receive accommodations. College may seem far away to those of us with babies and young children, but can you imagine any teen wanting to undertake a three- month “gluten challenge” in order to be tested for celiac disease? You can’t test for celiac disease if you have eliminated gluten before testing, unless you do a gluten challenge. Gluten sensitivity not mentioned. There is currently no reference to gluten sensitivity being covered by the Americans with Disabilities Act. Unfortunately, NCGS may not be accommodated until there is a formal definition and accepted diagnostic test. I hope I have convinced you to get celiac disease testing before starting a gluten- free diet or putting your child on one. It really is simple and inexpensive to do so. If you eliminate gluten before testing, it becomes very difficult to get an accurate diagnosis and in the long run may affect your pocketbook, your health and your family’s health. PLEASE PRINT THE FOLLOWING ARTICLE ON CELIAC DISEASE VS. GLUTEN SENSITIVITY FOR YOUR HEALTH CARE PROVIDER. My recent article in the Sonoma County Medicine Magazine was aimed at educating medical professionals on the topic of celiac disease vs. Burkhart: April/May 2. Reasons People Follow a Gluten Free Diet: 7 Types of Gluten Free Dieters March 2. Ten Positive Aspects of a Celiac Disease Diagnosis. February 2. 01. 6: Gluten Causes Keratosis Pilaris (a.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. Archives
November 2017
Categories |