““GLUTEN SENSITIVITY – FACT OR FICTION?”GLUTEN SENSITIVITY – FACT OR FICTION?”– Harveen K (harveenk26@gmail.com)Harveen K (harveenk26@gmail.com)

AGENDAAGENDA

All these patients presented with two or more combinations of these

symptoms. The symptoms were dizziness, abdominal pain,

fatigue, migraines, body aches, constipation, and temper tantrums

All these patients were tested negative for coeliac disease and were sent back and no treatment

was prescribed

“Clues to Gluten Sensitivity” published in WSJ (2011) reports case history of three patients.

“Coeliac Disease and Gluten Sensitivity” published by Food Reaction (2009) reports case history of a 28 year old woman.

GLUTEN SENSITIVITY: FACT OR FICTION?!

”Patients have been told if it wasn't coeliac disease, it wasn't anything. It was all in their heads," says Cynthia Kupper, executive director of the nonprofit Gluten Intolerance Group of North America

GLUTEN SENSITIVITY: FACT OR FICTION?!GLUTEN SENSITIVITY: FACT OR FICTION?!

Were these patients reporting with too vague non-specific symptom? or it wasn't anything?

GLUTEN SENSITIVITY: FACT OR FICTION?!GLUTEN SENSITIVITY: FACT OR FICTION?!

Move over fat, salt and sugar. There is a new dietary villain in town and it’s name is

GLUTENGLUTEN

Dietary Villains...

Dietary Villains...

GLUTEN SENSITIVITY: EMERGING DEFINITIONGLUTEN SENSITIVITY: EMERGING DEFINITION

“According to the recent definition of the term gluten sensitivity at the 11th International Coeliac Disease Symposium in Oslo, Norway in June 2011. Gluten sensitivity can be indistinguishable from coeliac disease or wheat allergy based on symptoms alone. It has been the catch all for people who feel better gluten free but whose labs don’t fit them into the first two categories” (Sapone et al., 2011)

“According to the recent definition of the term gluten sensitivity at the 11th International Coeliac Disease Symposium in Oslo, Norway in June 2011. Gluten sensitivity can be indistinguishable from coeliac disease or wheat allergy based on symptoms alone. It has been the catch all for people who feel better gluten free but whose labs don’t fit them into the first two categories” (Sapone et al., 2011)

GLUTEN SENSITIVITY: SYMPTOMSGLUTEN SENSITIVITY: SYMPTOMS

(Sapone et al., 2011)(Sapone et al., 2011)

– .

Volta U, De Giorgio R, 2012Volta U, De Giorgio R, 2012

GLUTEN SENSITIVITY: DIFFERS FROM COELIAC DISEASEGLUTEN SENSITIVITY: DIFFERS FROM COELIAC DISEASE

GLUTEN SENSITIVITY: DIAGNOSISGLUTEN SENSITIVITY: DIAGNOSIS

The following list summarizes the identification of gluten sensitivity:The following list summarizes the identification of Gluten sensitivityThe following list summarizes the identification of Gluten sensitivity

(Sapone et al., 2011)(Sapone et al., 2011)

GLUTEN SENSITIVITY: NEW UNDERSTANDINGGLUTEN SENSITIVITY: NEW UNDERSTANDING

(Volta U, De Giorgio R, 2012)(Volta U, De Giorgio R, 2012)

GLUTEN SENSITIVITY: EVIDENCE-BASED MEDICAL LITERATUTRE

GLUTEN SENSITIVITY: TREATMENT & PREVENTIONGLUTEN SENSITIVITY: TREATMENT & PREVENTION

GLUTEN SENSITIVITY: TREATMENT AND PREVENTIONGLUTEN SENSITIVITY: TREATMENT AND PREVENTION

(WSJ, 2011)(WSJ, 2011)

GLUTEN SENSITIVITY: FURTHER RECOMMENDATIONS FOR RESEARCHGLUTEN SENSITIVITY: FURTHER RECOMMENDATIONS FOR RESEARCH

QUESTIONS? (Easy ones please QUESTIONS? (Easy ones please ))

Hadjivassiliou M, Sanders D, Grünewald RA, Woodroofe N, Boscolo S, Aeschlimann D. Gluten sensitivity: from gut to brain. Lancet Neurol 2010; 9: 318–30

Jessica R. Biesiekierski, Newnham ED, Irvin PM, Barret JS, Haines M, Doecke DJ, Shepherd SJ, B, Jane G. Gibson PR. Gluten Causes Gastrointestinal Symptoms in Subjects Without Coeliac Disease: A Double-Blind Randomized Placebo-Controlled Tria . Am J Gastroenterol advance online publication, 11 January 2011; doi: 10.1038/ajg.2010.487

Sapone A, Bai J, Ciacc C, Dolinse J, HR P Green, Hadjivassiliou M, Kaukinen K, Rostami K, Sander D, Schumann M, Ullrich R, Villalta D, Volta U, Fasano A. Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Medicine 2012, 10:13 doi:10.1186/1741-7015-10-1.

Sapone A, Karen M. Lammers B, Mazzarella G, Mikhailenkoc I, Cartenìa M, Casolarob V, Fasanob A. Differential Mucosal IL-17 Expression in Two Gliadin-Induced Disorders: Gluten Sensitivity and the Autoimmune Enteropathy Coeliac Disease. Int Arch Allergy Immunol 2010;152:75–80 DOI: 10.1159/000260087.

Sapone A, Karen M. Lammers B, Casolaro V, Cammarota M, Giuliano T, De Rosa M, Stefanile R, Mazzarella G , Russo MI, Esposito P, Ferraraccio F, Cartenì M, Riegler G, Magistris L, Fasano A. Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: coeliac disease and gluten sensitivity. BMC Medicine 2011, 9:23 doi:10.1186/1741-7015-9-23

Volta U, Giorgio R. New understanding of gluten Sensitivity. Nature Reviews Gastroenterology & Hepatology 9, 295-299 (May 2012) doi: 10.1038/nrgastro.2012.15

Wahnschaffe U, Schulzke J, Zeitz M, Ullrich R. Predictors of Clinical Response to Gluten-Free Diet in Patients diagnosed with diarrhoea-dominant irritable bowel syndrome. Clinical Gastroenterology & Hepatology 2007 Coeliac Disease and Gluten Sensitivity. http://www.foodreactions.org/gluten/ accessed on 25.11.2012Clues to Gluten Sensitivity. http://online.wsj.com/article/SB10001424052748704893604576200393522456636.html accessed on 25.11.2012

REFERENCES