Clan Thompson's Celiac Site

Q & A

QUESTION: Dr. Kenneth Fine of Dallas has a different test for celiac disease. His theory, which sounds very logical, is that if gluten is going to cause a problem, it's going to show up first in the large intestine as the waste containing gluten passes thru. He tests the stool for antibodies to gluten.

It takes time and medical journal articles for a new theory to be accepted. Dr. Fine is in the process.

As a health care consumer it seems to me that the blood testing and biopsy testing for celiac disease are far from ideal. On one celiac discussion forum I have seen countless tales of people who have had a very hard time getting a diagnosis. One woman wrote in whose seven year old son tested negative 3 times on the blood tests and it wasn't until the 3rd endoscope that celiac was diagnosed!

Have you heard of this type of testing? What do you think?

I always enjoy your Ask the Doctor column.

DR. RUDERT: Dr. Kenneth Fine of Dallas is an outstanding researcher and clinician. I had the pleasure of speaking with him at the recent International Meeting for Celiac Disease in Baltimore and he is also a founding member of the Celiac Standardization Group formed by Elaine Monarch of the Celiac Disease Foundation (CDF).

His lab, EnteroLab, provides genetic testing and stool testing for gluten sensitivity and Celiac Disease. I have recommended his lab to my patients and we have utilized his services. Any questions you have pertaining to his tests should be addressed to Dr. Kenneth Fine at his website http://www.finerhealth.com.

I most certainly agree with you that present testing is far from ideal. I have spoken with other leaders in Celiac Disease that feel that potentially up to 20% of individuals may be seronegative. Also, physicians need to be aware that tissue transglutaminase positivity correlates with total villous atrophy. I have often wondered how many individuals may be missed that present with milder damage and have not yet progressed to total villous atrophy. Thank you for your kind comments.

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