varanophile
Active Member
Hi all,
At any point in time there seem to be several fad health concerns going around, and I would include "gluten allergy" as one currently.
Whilst there is a definite spectrum of disorders related to sensitivities that do affect a relatively significant proportion of the population, it is important to remember that these have specific guidelines for diagnosis. If you suspect the diagnosis, then it is important to seek definitive testing to rule out the more serious disorders in the spectrum. The spectrum includes Coeliac disease, true wheat allergy, gluten induced neuropathy, and the so called "idiopathic" (i.e. cause not currently clear) gluten sensitivity. Combined these disorders are thought to affect approximately 5% of the population, however once the clearly defined and diagnosable forms are removed this leaves a small number in the idiopathic grouping. By definition a diagnosis of idiopathic cause can only be given when other causes are ruled out through diagnostic testing, and positive results are obtained from gluten challenge. Please note a diagnosis of idiopathic cause does not necessarily mean no positive findings on testing as most will show some evidence of sensitivity on immunological and/or histological tests.
Diagnosis should not be given before testing (including bloods, immunological, and biopsy). The most common symptoms described with gluten sensitivity (bloating, fatigue, cramping, poor bowel habits) also fit many other disorders, and are therefore poor diagnostic criteria. When diagnosis is based on poorly defined correlations, such as by self diagnosis or by those who do not have specialist training in the area (and I include those who practice complementary medicine), this can lead to problems in several ways. Firstly the patient may fall into known disorders, such as Coeliac disease, which warrants ongoing specialist review due to possible serious outcomes and strict treatment guidelines. Secondly and probably more commonly, the diagnosis may be given when no sensitivity exists, leading to people undertaking extreme treatments/diets without need, or more worryingly missing a serious cause unrelated to gluten.
Sorry to have a rant, but I do think people need to be cautious when taking and given advice based on limited information/knowledge of the individual and disease. Please do not think I am against discussions such as this one, as they can lead to increased community awareness, and may help those with undiagnosed disease seek the care they need.
At any point in time there seem to be several fad health concerns going around, and I would include "gluten allergy" as one currently.
Whilst there is a definite spectrum of disorders related to sensitivities that do affect a relatively significant proportion of the population, it is important to remember that these have specific guidelines for diagnosis. If you suspect the diagnosis, then it is important to seek definitive testing to rule out the more serious disorders in the spectrum. The spectrum includes Coeliac disease, true wheat allergy, gluten induced neuropathy, and the so called "idiopathic" (i.e. cause not currently clear) gluten sensitivity. Combined these disorders are thought to affect approximately 5% of the population, however once the clearly defined and diagnosable forms are removed this leaves a small number in the idiopathic grouping. By definition a diagnosis of idiopathic cause can only be given when other causes are ruled out through diagnostic testing, and positive results are obtained from gluten challenge. Please note a diagnosis of idiopathic cause does not necessarily mean no positive findings on testing as most will show some evidence of sensitivity on immunological and/or histological tests.
Diagnosis should not be given before testing (including bloods, immunological, and biopsy). The most common symptoms described with gluten sensitivity (bloating, fatigue, cramping, poor bowel habits) also fit many other disorders, and are therefore poor diagnostic criteria. When diagnosis is based on poorly defined correlations, such as by self diagnosis or by those who do not have specialist training in the area (and I include those who practice complementary medicine), this can lead to problems in several ways. Firstly the patient may fall into known disorders, such as Coeliac disease, which warrants ongoing specialist review due to possible serious outcomes and strict treatment guidelines. Secondly and probably more commonly, the diagnosis may be given when no sensitivity exists, leading to people undertaking extreme treatments/diets without need, or more worryingly missing a serious cause unrelated to gluten.
Sorry to have a rant, but I do think people need to be cautious when taking and given advice based on limited information/knowledge of the individual and disease. Please do not think I am against discussions such as this one, as they can lead to increased community awareness, and may help those with undiagnosed disease seek the care they need.