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

                               “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.




All these patients presented with two or more
     combinations of these symptoms. The            All these patients were tested negative for
 symptoms were dizziness, abdominal pain,          coeliac disease and were sent back and no
fatigue, migraines, body aches, constipation,                treatment was prescribed
             and temper tantrums
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




     Were these patients reporting with too vague non-specific symptom? or it
                                  wasn't anything?
GLUTEN SENSITIVITY: FACT OR FICTION?!



                      Dietary
                       Dietary
                      Villains..
                       Villains..
                      ..




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




“According to the recent definition of the term gluten sensitivity at the 11th
 “According to the recent definition of the term gluten sensitivity at the 11th
International Coeliac Disease Symposium in Oslo, Norway in June 2011. Gluten
 International Coeliac Disease Symposium in Oslo, Norway in June 2011. Gluten
sensitivity can be indistinguishable from coeliac disease or wheat allergy based
 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
 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.,
 free but whose labs don’t fit them into the first two categories” (Sapone et al.,
2011)
 2011)
GLUTEN SENSITIVITY: SYMPTOMS




                  (Sapone et al., 2011)
                   (Sapone et al., 2011)
GLUTEN SENSITIVITY: DIFFERS FROM COELIAC DISEASE

– .




                             Volta U, De Giorgio R, 2012
                              Volta U, De Giorgio R, 2012
GLUTEN SENSITIVITY: DIAGNOSIS

The following list summarizes the theidentificationof Gluten sensitivity
 The following list summarizes theidentification of Gluten sensitivity
                      The following list summarizes identification of gluten sensitivity:




                                                                                 (Sapone et al., 2011)
                                                                                  (Sapone et al., 2011)
GLUTEN SENSITIVITY: NEW UNDERSTANDING




                        (Volta U, De Giorgio R, 2012)
                         (Volta U, De Giorgio R, 2012)
GLUTEN SENSITIVITY: EVIDENCE-BASED MEDICAL
                               LITERATUTRE
GLUTEN SENSITIVITY: TREATMENT & PREVENTION
GLUTEN SENSITIVITY: TREATMENT AND PREVENTION




                                     (WSJ, 2011)
                                      (WSJ, 2011)
GLUTEN SENSITIVITY: FURTHER RECOMMENDATIONS FOR
                                      RESEARCH
QUESTIONS? (Easy ones please  )
REFERENCES
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 25.11.2012
Clues to Gluten Sensitivity. http://online.wsj.com/article/SB10001424052748704893604576200393522456636.html
accessed on 25.11.2012

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Gluten sensitivity v7.0

  • 1. “ GLUTEN SENSITIVITY – FACT OR FICTION?” – Harveen K (harveenk26@gmail.com)
  • 3. GLUTEN SENSITIVITY: FACT OR FICTION?! “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. All these patients presented with two or more combinations of these symptoms. The All these patients were tested negative for symptoms were dizziness, abdominal pain, coeliac disease and were sent back and no fatigue, migraines, body aches, constipation, treatment was prescribed and temper tantrums
  • 4. 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 Were these patients reporting with too vague non-specific symptom? or it wasn't anything?
  • 5. GLUTEN SENSITIVITY: FACT OR FICTION?! Dietary Dietary Villains.. Villains.. .. Move over fat, salt and sugar. There is a new dietary villain in town and it’s name is GLUTEN
  • 6. GLUTEN SENSITIVITY: EMERGING DEFINITION “According to the recent definition of the term gluten sensitivity at the 11th “According to the recent definition of the term gluten sensitivity at the 11th International Coeliac Disease Symposium in Oslo, Norway in June 2011. Gluten International Coeliac Disease Symposium in Oslo, Norway in June 2011. Gluten sensitivity can be indistinguishable from coeliac disease or wheat allergy based 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 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., free but whose labs don’t fit them into the first two categories” (Sapone et al., 2011) 2011)
  • 7. GLUTEN SENSITIVITY: SYMPTOMS (Sapone et al., 2011) (Sapone et al., 2011)
  • 8. GLUTEN SENSITIVITY: DIFFERS FROM COELIAC DISEASE – . Volta U, De Giorgio R, 2012 Volta U, De Giorgio R, 2012
  • 9. GLUTEN SENSITIVITY: DIAGNOSIS The following list summarizes the theidentificationof Gluten sensitivity The following list summarizes theidentification of Gluten sensitivity The following list summarizes identification of gluten sensitivity: (Sapone et al., 2011) (Sapone et al., 2011)
  • 10. GLUTEN SENSITIVITY: NEW UNDERSTANDING (Volta U, De Giorgio R, 2012) (Volta U, De Giorgio R, 2012)
  • 11. GLUTEN SENSITIVITY: EVIDENCE-BASED MEDICAL LITERATUTRE
  • 13. GLUTEN SENSITIVITY: TREATMENT AND PREVENTION (WSJ, 2011) (WSJ, 2011)
  • 14. GLUTEN SENSITIVITY: FURTHER RECOMMENDATIONS FOR RESEARCH
  • 15. QUESTIONS? (Easy ones please  )
  • 16. REFERENCES 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 25.11.2012 Clues to Gluten Sensitivity. http://online.wsj.com/article/SB10001424052748704893604576200393522456636.html accessed on 25.11.2012