Discussion: Celiac Disease and Gluten Sensitivity with Yale Professor Dr. Marie Robert, GI Specialist

Celiac Disease versus Gluten Sensitivity

Is it celiac disease. . . or something else?


That’s the question asked by Life Extension’s Michael A. Smith, MD, in his timely interview with Dr. Marie Robert, a nationally recognized gastrointestinal surgical pathologist and Professor of Pathology and Medicine at Yale University School of Medicine. Download this Live Foreverish podcast episode for FREE!


What is the difference between celiac disease and gluten sensitivity?


Celiac Disease VS Non-Celiac Gluten Sensitivity

Everyone appears to be jumping on the gluten-free bandwagon these days. And while approximately 1% of the population has celiac disease, an autoimmune disorder that prevents them from consuming gluten-containing food, others just feel better without gluten.1 The latter may have non-celiac gluten sensitivity, a medically-recognized phenomenon that occurs in an estimated 0.5 to 13% of the population.2

What is gluten?

Gluten is a mixture of two types of proteins in cereal grains that include wheat, rye and barley. Gluten is a Latin word meaning glue, which is an apt description for the elastic property gluten imparts to dough. Because wheat is the most commonly consumed grain in the US and many other parts of the world, gluten can be hard to avoid.

Related Article: Top 5 Questions About Gluten Answered

What are some of the signs and symptoms of celiac disease?

Possible adverse effects associated with celiac disease include bloating, gas or abdominal pain, diarrhea, constipation, general fatigue, itchy skin, tooth discoloration, joint pain, irritability, weight loss, delayed growth in children, fractures and thin bones, migraines, infertility, miscarriages, and an association with other autoimmune diseases. Many of these celiac disease symptoms are also associated with non-celiac gluten sensitivity.

Is there a test for celiac disease?

A simple and inexpensive blood test for anti-tissue transglutaminase antibody IgA can provide a celiac disease diagnosis in over 90% of those who have the disease. The test detects the presence of an antibody to an enzyme in the body known as tissue transglutaminase, which is attacked by the immune system in celiac disease. Since a minority of individuals can have false negative celiac disease test results, concomitant testing of other factors such as deamidated gliadin IgA and serum IgA is suggested.3,4

Non-celiac gluten sensitivity is currently only diagnosed by gluten withdrawal and a double-blind placebo-controlled gluten challenge.5

Because celiac disease is associated with a number of adverse effects, some of which may not be reversible, Dr. Robert recommends diagnostic testing as soon as possible when the disease is suspected.

What should I do if I am diagnosed with celiac disease?

If I’m diagnosed with celiac disease, I just avoid gluten, right?

It’s easier said than done. There is presently no cure for celiac disease, only management with a celiac disease diet, which involves avoiding gluten-containing foods. While there are now many foods on the shelves of most supermarkets that are certified as “gluten-free,” eating out in restaurants, going away to college, attending parties, etc., can be challenging.

Related Article: How To Go Gluten Free in 5 Steps

“The burden of disease is very high on individuals and their families,” Dr. Robert observed. “But I’m happy to say there are 13 drugs in clinical trials now at various stages and some of them have shown great promise to allow for a better life for patients with celiac disease, even to the point of perhaps inducing a tolerance so that one doesn’t react anymore.”

However, approval of these drugs is still five years away, according to Dr. Robert’s estimation. She encourages those who are interested to visit clinicaltrials.gov to view a list of celiac disease trials that may be accepting new enrollees. It’s important for patients to volunteer for research that could significantly impact their lives and that of others with the disease by advancing the approval of new therapies. Some of these compounds could eventually allow those with celiac disease to resume a normal eating pattern.

Dr. Robert re-emphasized the importance of testing to rule out celiac disease if one is experiencing any of its symptoms. She urged against following a gluten-free diet as a result of self-diagnosis.

“That really muddies the waters and may not be necessary.”

Life Extension has additional information about celiac disease and non-celiac gluten sensitivity for those who wish to learn more about either condition.

References
  1. Lebwohl B et al. BMJ. 2015 Oct 5;351:h4347.
  2. Molina-Infante J et al. Aliment Pharmacol Ther. 2015 May;41(9):807-20.
  3. Leffler DA et al. Am J Gastroenterol. 2010 Dec;105(12):2520-4.
  4. Volta U et al. Expert Rev Gastroenterol Hepatol. 2010 Feb;4(1):31-5.
  5. Barbaro MR et al. F1000Res. 2018 Oct 11;7.

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