“inside the monolith of gluten avoidance lurk multiple, nuanced conditions”
Elena Verdù, a gastroenterologist at McMaster University in Hamilton, Canada, president of the North American Society for the Study of Celiac Disease
Love that quote! It’s taken from this very long article in Science (shared by one of you on the FB group, thank you!) Essentially, it reflects the ongoing argument about what is causing gluten issues in people – and is it even gluten? There is much debate going on about whether people have non-coeliac gluten sensitivity, a different form of coeliac disease, a FODMAP issue, is a gluten sensitivity an immune, autoimmune or non-immune reaction blah-de-blah-de-blah! (See my article here on that too).
Then we get to the end of the article and Ms Verdu gets it spot on. There are many causes! People have varying problems – I find clinically it can be anything from a ‘simple’ inability to break gluten down due to lack of stomach acid and enzymes, right up to an autoimmune problem with maybe lectins promoting intestinal permeability. And it can be multiple causes of course; these things are hardly ever just one thing.
Just because we haven’t pinpointed yet what the problem is, does not mean we shouldn’t be treating people for it either. Another fab quote from the article from the famed gluten doctor Dr Alessio Fasano, a pediatric gastroenterologist at Massachusetts General Hospital in Boston who has studied NCGS. He was responding to the question as to why many doctors are giving a gluten free diet and helping patients anyway no matter what the science says:
“If I have to throw bones on the ground and look at the moon to make somebody better, even if I don’t understand what that means, I’ll do it.”
Too flaming right, good for him! I hooted at that.