Gluten sensitivity: Are we expecting too much of colonoscopy?


It seems more people than ever are requesting colonoscopies believing it will detect gluten intolerance. But the director of the Food Intolerance Institute Deborah Manners explains why the procedure does not give proof of inability to digest gluten.

According to the Australian Atlas of Healthcare Variation an increasing number of people are requesting colonoscopies at the GP. Professor Jane Andrews from Adelaide University says many are unnecessary – blaming the ‘worried well’ and the ‘gluten-free’ movement. Professor Andrews also singles out naturopaths who may suspect gluten intolerance and recommend the procedure. shutterstock_35462977

Manners: ‘Our concern is there is major misunderstanding amongst consumers – and naturopaths. Anyone who believes a colonoscopy will give a Yes/No answer on gluten intolerance is mistaken.

No longer for a special few – the gluten-free diet has gone mainstream – even including supermarket generics: fresh sausages, snack foods, pasta and baked goods.

Unfortunately, as with all new information – things get misinterpreted, wires get crossed and confusion sets in. ‘Even Celiac disease – a rather uncommon variation of gluten intolerance where the lining of the small intestine is damaged cannot be diagnosed by colonoscopy’, says Manners.

For clarity: a colonoscopy examines only the large intestine via the anus with a tiny camera. There are three possible outcomes:

  1. A positive finding: bowel tissue damage, pre-cancerous polyps or other findings – which might suggest adverse effects of gluten – amongst other causes
  2. An ‘inconclusive’ finding: a common outcome – usually calling for further investigation
  3. A negative finding: no tissue damage or other abnormalities found

The third possibility is the problem. If a negative finding is taken as an ‘all clear’ regarding gluten intolerance – we are expecting too much from colonoscopy.

‘I think people misunderstand: there are two types of intestine. A colonoscopy only picks up abnormalities in the colon (large bowel). Gluten intolerance, on the other hand – damages the small intestine. But the gluten protein – and its breakdown fragments can impact many parts of the body.

In addition gluten intolerance masquerades as a raft of chronic diseases: rheumatoid arthritis, multiple sclerosis, eczema, psoriasis, infertility, heart disease, thyroid disease, infertility, diabetes type 1, metabolism issues including obesity – and other conditions.

Adjusting the diet to substitute gluten often relieves symptoms and arrests disease progress says Manners.

The bottom line? Don’t be misled by negative colonoscopy result. It does not mean you are home free.

‘Our concern is that consumers might use a negative colonoscopy result as a green light to carry on eating gluten-bearing foods like bread, pasta, cereals, beer and malt.

‘The damaging effects of gluten on the human body are so many and varied that they are still being documented in the medical literature,’ she says. A small cross-section (dozens) of references are listed on the Institute’s website: http://www.foodintol.com/references-from-medical-journals

‘Put simply – the human body is not “equipped” to fully digest gluten. There is only partial digestion – releasing foreign gliadins and glutenins into the bloodstream. Consequences include tissue damage, inflammation or organ malfunction – with a gradual slide into chronic disease.

She says ‘the very great prevalence of chronic disease in Australia (three in four people have one or more chronic diseases by age sixty five) is hard evidence of the impact of gluten and other ‘anti nutrients’ in our community.’

Even ‘no symptoms’ can mean food intolerance is present.

Although the ‘worried well’ are often disparaged in the media – perhaps we could cut them a little slack. These folk are trying to get answers – and finding out sooner rather than later could save them from a diagnosis. She says tracking changes in symptoms as you switch foods (with a $2 blank exercise book) is much more accurate – and a whole lot less trouble and expense than a colonoscopy.

Savvy consumers are beginning to understand that food intolerance frequently has no symptoms at all. People still have ailments – but they tend to blame something else: a bout of the ‘flu, a change in the weather, being ‘rundown’ – or just stress. By the time symptoms are noticed – a preventable disease may be imminent.

We urge anyone who has never thought about food intolerance to begin considering it. The best way is – test yourself on different foods in a methodical way. Gluten intolerance is easily found using a journal and comprehensive food guide.

Regarding the worried well  . . . ‘call it what you like’, says Manners – ‘we know there is no better preventative health measure than a brisk awareness of one’s state of health.’

Gluten symptoms vanish on Paleo!

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