There are several ways to test for Sjögren’s which I have added below, even though I have an Article on this very topic posted at the Gluten Free Help website.

I personally had the eye test done (brings back memories) and then the blood test done. I have an account with a lab and can order tests through my clinic (Karmic Health), so I will also check to see if there is a simple test that can be ordered.

So, how is Sjögren’s Syndrome diagnosed?

http://www.medicinenet.com/sjogrens_syndrome/article.htm

The diagnosis of Sjögren’s syndrome involves detecting the features of dryness of the eyes and mouth. The dryness of the eyes can be determined in the doctor’s office by testing the eye’s ability to wet a small testing paper strip placed under the eyelid (Schirmer’s test using Schirmer tear test strips). More sophisticated eye testing can be done by an eye specialist (ophthalmologist). Salivary glands can become larger and harden or become tender. Salivary-gland inflammation can be detected by radiologic nuclear medicine salivary scans. Also, the diminished ability of the salivary glands to produce saliva can be measured with salivary flow testing. The diagnosis is strongly supported by the abnormal findings of a biopsy of salivary-gland tissue.

The glands of the lower lip are often used to obtain a biopsy sample of the salivary-gland tissue in the diagnosis of Sjögren’s yndrome. The lower lip salivary-gland biopsy procedure is easily performed under local anesthesia, with the surgeon making a tiny incision on the inner part of the lower lip, to expose and remove a sample of the tiny salivary glands within.

Patients with Sjögren’s syndrome typically produce a myriad of extra antibodies against a variety of body tissues (autoantibodies). These can be detected through blood testing and include antinuclear antibodies (ANAs), which are present in nearly all patients. Typical antibodies that are found in most, but not all patients, are SS-A and SS-B antibodies, rheumatoid factor, thyroid antibodies and others. Low red blood count (anemia) and abnormal blood testing for inflammation (sedimentation rate) are seen.

Another link with a list of tests, etc.

http://www.wrongdiagnosis.com/s/sjogrens_syndrome/tests.htm

Sandi Star, CCN

You can read all about Sandi Star’s remarkable story in her 3-part article series available at the following links:  Living Gluten Free – Right to Heal – Part I, Living Healthy, Without Gluten and Dairy– Part II, Living Healthy, Without Gluten and Dairy Part III.  Afterwards, read Sandi’s information-packed article and true story: Going Blind.

About the author: Sandi Star, CCN Sandi is the founder of Karmic Health, specializing in nutrition related to disease where a gluten and casein (dairy) free lifestyle is crucial; working with celiac, autism and all auto immune disorders. Sandi graduated from The Natural Healing Institute with a degree in Clinical Nutrition and is continuing her studies in Clinical Herbology. She has hands on understanding of many health issues and has dedicated her life in helping others reach their optimal health.

For more information related to this article  (or her previous articles) please visit www.karmic-health.com or contact Sandi Star at 760.685.3154.

Tina Turbin
www.GlutenFreeHelp.info

Looking to get tested for celiac disease?

Conventional testing methods, such as intestinal biopsies and blood testing, can often be inaccurate. However, now you can bypass a doctors visit and test yourself for the disease with one-hundred-percent accurate DNA testing.

How does it work? A test kit is mailed to one’s home which doesn’t require needles or drawing blood but only calls for two cheek swabs. There is thus confidentiality maintained between a person and his insurance company. The results are also quickly returned with a simple positive or negative result, plus a helpful video available for download in the case that one’s results are positive. Additionally, families receive a discount when they purchase 2 or more kits.

Who may be a candidate? Anyone who has intestinal troubles, chronic fatigue, chronic anemia, skin disorders like eczema, psychological problems, child mental disorders like ADD or autism, diabetes, or any autoimmune disease like rheumatoid arthritis.

For more information, visit: http://www.glutenfreesociety.org/genetic-testing-for-gluten-sensitivity.

Tina Turbin
www.GlutenFreeHelp.info

Why the problem with gluten now? A lot has changed in the way we harvest food compared to 50 years ago. Some of the seed companies began engineering wheat kernels that could be more easily ground and produce fluffier flour to make the soft, delicious white bread for example had to have greater yields; it made more money for the farmer and increased sales.

Gluten is a composite of the proteins gliadin and glutenin. These exist, conjoined with starch, in the endosperms of some grass-related grains, notably wheat, rye, and barley.

Understanding what happens in the body and some of the symptoms will help millions of people who go undiagnosed. Celiac is the most common genetic disease of mankind (yet for every person diagnosed, 140 will go undiagnosed).

Levels of Intolerance A wheat allergy is the body’s abnormal autoimmune response to a certain protein component of wheat; it’s exhibited by a severe sudden onset allergic reaction. Usual symptoms are immediate coughing, asthma, breathing difficulties, and/or projectile vomiting. It can cause life-threatening responses in allergic people. A true Wheat allergy affects less than 1/2 % of population.

Intolerance’s are much more common than true food allergies but are harder to diagnose. Food intolerance is an adverse reaction to food that does not involve the body’s immune system. Generally food intolerance is an inability to properly digest certain foods. In some cases food passes right through the body before digestion is complete.

Leaky Gut is an increase in permeability of the intestinal mucosa to luminal macromolecules, antigens, and toxins associated with inflammatory degenerative and/ or atrophic mucosa or lining. Put more simply, large spaces develop between the cells of the gut wall allowing bacteria, toxins and food to leak into the bloodstream. Leaky Gut Syndrome has also been linked with many conditions, such as: Celiac Disease, Multiple Sclerosis, Fibromyalgia, Autism, Chronic Fatigue Syndrome, Irritable Bowel Syndrome, Eczema, Dermatitis, and Ulcerative Colitis.

Celiac disease is an autoimmune disease caused by an inappropriate immune response to dietary proteins found in wheat, rye, and barley (gluten and gliadin). This response leads to inflammation of the small intestine and to damage and destruction of the villi that line the intestinal wall. These villi are projections (small folds) that increase the surface area of the intestine and allow nutrients, vitamins, minerals, fluids, and electrolytes to be absorbed into the body. When the villi are destroyed, the body is much less capable of absorbing food and begins to develop symptoms associated with malnutrition and malabsorption. When the body is exposed to the gluten and gliadin proteins, it forms antibodies that recognize and act against not only the grain proteins, but also against constituents of the intestinal villi. As long as the patient continues to be exposed to the proteins, he will continue to produce these autoantibodies. Celiac disease is found throughout the world but is most prevalent in those of European descent. It can affect anyone at any age and is more common in women. It is thought to be an inherited tendency that is triggered by an environmental, emotional, or physical event – although the exact mechanism is not fully understood.

According to the National Digestive Diseases Information Clearinghouse, about 5 to 15% of close family members of a celiac disease patient will also have the condition.

One of the questions I have is if someone gets a negative test for celiac should they still go gluten free. My answer is yes. If you are experiencing any of the symptoms you are more than likely gluten intolerant. Most of the population fits in that category including me. I recommend doing the 45 – 60 day challenge. Try going gluten free and pay attention to your health. If you see changes and feel better you are better off gluten free. You just have to make sure you eat a healthy gluten free diet.

Symptoms There are literally dozens, if not hundreds, of symptoms of gluten intolerance. It all comes down to inflammation in the body! Many people believe the most common symptoms are gastrointestinal in nature – yet the majority of people with gluten intolerance (and celiac disease) have extraintestinal symptoms.

The most common symptoms of celiac disease include:

• Fatigue

• Addison’s disease (hormonal disorder)

• Gastrointestinal distress (gas, bloating, diarrhea, constipation, vomiting, reflux)

• Headaches (including migraines)

• Infertility

• Mouth sores

• Weight loss/gain

• Inability to concentrate

• Moodiness/depression

• Amenorrhea/delayed menarche (menstrual cycles)

• Bone/joint/muscle pain

• Dental enamel hypoplasia (dental enamel defect)

• Short stature

• Seizures

• Tingling numbness in the legs

The “cure” is a life long gluten free diet.

Next month I’ll discuss some steps to take in making the transition.

About the author: Sandi Star, CCN Sandi is the founder of Karmic Health, specializing in nutrition related to disease where a gluten and casein (dairy) free lifestyle is crucial; working with celiac, autism and all auto immune disorders. Sandi graduated from The Natural Healing Institute with a degree in Clinical Nutrition and is continuing her studies in Clinical Herbology. She has hands on understanding of many health issues and has dedicated her life in helping others reach their optimal health.

For more information related to this article please visit www.karmic-health.com or contact Sandi Star at 760.685.3154

© Copyright Karmic Health 2010

I am originating and authorizing Tina Turbin to share this story with you.

Maureen has generously offered to share her continued story as time progresses. Check back for Part 3 or sign up for the RSS feed on the right hand column.(this means you will get updates sent to you in case you are not familiar with this feature) Read Part 1

“Here is my first tip to anyone going through a difficult diagnosis: go with your instincts and find a doctor who you trust, who is kind, compassionate and willing to listen to you as a person. Switching doctors saved my life – I have no doubt in my mind.”

Everyone has a story to tell and my journey toward living a healthy, gluten-free lifestyle is a unique story, one of which I hope will give other people hope for living a “ full” filled life after years of frustrations, tests, diagnosis and acceptance. From my personal experience, I can understand why someone would not feel fulfilled and would almost feel deprived being thrown into a situation where they can no longer eat the foods they have grown to love and share with their family and friends, but when the order was given for me to go gluten free, I was willing to do anything to feel better and bring a sense of normalcy and peace back into my life and that of my family. My name is Dr. Maureen Ellis, and I have Systemic Lupus Erythemtosus (SLE), which is a chronic autoimmune connective tissue disease that can affect any part of the body where the immune system attacks the body’s cells and tissue, resulting in inflammation and tissue damage. Lupus has affected my central nervous system, gastrointestinal tract, biliary tract and pancreas. Please join me in my adaptation to a “full” filling gluten-free lifestyle.

After my children were born I decided to get my master’s degree. I fell in love with higher education and decided to pursue my Ph.D. I successfully defended my dissertation the month before I turned 41 and started my first tenure-track position two months later at a research institution. I felt like everything in my life had fallen into place and it was finally time to enjoy the fruits of my labor. We had a beautiful home, two great kids, my husband loved his job and we were starting to make our new environment feel like home. In April 2005, I went in for my annual exam and my doctor found a lump in my left breast. Without delay I had numerous tests and ended up in a surgeon’s office who immediately scheduled me for a lumpectomy to remove the tumor. He was 95% sure that my lump was cancerous. Believe it or not, the tumor was benign, but something went terribly wrong during surgery; it appeared as if my computer had decided not to reboot because when I woke up on May 7, 2005, nothing in my life would ever be the same. Now that I have been fully diagnosed, the doctors believe that Lupus had been a sleeping giant waiting to be woken up and we have been able to go through my childhood and realize that the symptoms of gluten intolerance and GI disorders have been a part of my life since I was a small child.

Following the lumpectomy, I couldn’t keep food down, had constant diarrhea and eventually became dehydrated so I was admitted back into the hospital. They hooked me up to an IV and some good drugs then sent me home to recuperate, only to find myself readmitted twice in the next couple of weeks. The doctors in the hospital said it was time to get to a specialist that there was definitely something strange going on inside. One doctor mentioned Crones Disease and Colitis so next step was making an appointment with a gastroenterologist. I went in expecting to get help and start feeling better soon as I was teaching summer school and it was tough when I didn’t have any energy. Right away he was positive it was Crones Disease, which is an inflammatory bowel disease or Celiac Sprue, which is an autoimmune disorder of the small intestine causing a mal-absorption syndrome from the ingestion of gluten-containing foods . I had the usual battery of tests like a sigmoidoscopy, upper GI, several blood and stool tests, all of which came back negative, except I had exceptionally fast transit and was trans-absorbing nutrients, which meant that my food was moving through my GI tract so fast that I wasn’t able to absorb any of the nutrients so I was suffering from malnutrition. Since I was continuing to lose weight from the chronic diarrhea and I was losing my appetite for food, I started pushing the doctor for answers, especially since we were already into early August and I wanted to be well before the new school year started. Looking back now, that was such an unrealistic goal as it took four years to get a complete diagnosis. In the meantime, the doctor suggested we start eliminating lactose to see if that helped and sadly enough, getting rid of my morning latte did help some with the gas and bloating but diarrhea was still running my life. I knew that as soon as I ate, within 20 minutes I would head straight to the bathroom with severe cramping and watery diarrhea. My life was literally revolving around what I ate, when I ate and then my distance to a bathroom. I started to feel isolated and was afraid to go out in public for fear there wouldn’t be a bathroom close enough when the trots came on. I had severe debilitating pain in my upper-right quadrant to the point I felt like I was being stabbed by a knife. One night I lay in bed planning my funeral because I was afraid to wake my husband and tell him I thought I was dying.

About a week before the fall semester began I prepared and had my colonoscopy and an endoscopy. And yes its true, the prep is far worse than the actual procedure because I remember nothing. The problem was that I never recovered and started becoming very, very sick. The results were basically inconclusive for everything. He took several biopsies and said he could rule out Crones for now, but it could be Celiac, but for now he would go with Irritable Bowel Syndrome (IBS). When I woke up, I about went insane because I knew in my heart of hearts this was something more serious than IBS. This was not stress related or because of something I ate, but something had gone terribly wrong with that surgery and I needed someone who would get to the bottom of it. I felt very alone and scared. Unfortunately at this point I didn’t have any energy to fight this doctor. By the end of the weekend, I was too weak to get out of bed so my husband called the doctor’s office and thankfully, he was on vacation. This gave my husband the idea to call our former landlord who was a Gastroenterologist. He explained what was going on and said, “Maureen is dying can you do anything for her”. My new doctor rode in on his white horse with his white hat on and very gently took over my case. Here is my first tip to anyone going through a difficult diagnosis: go with your instincts and find a doctor who you trust, who is kind, compassionate and willing to listen to you as a person. Switching doctors saved my life – I have no doubt in my mind.

My new doctor put me on some meds to get me through the weekend and I went in to see him the next Monday.  After looking at my medical history and test results, he said, I think I know what’s wrong with you but you’re going to have to trust me on this. And this is
the moment when my journey changed. The first step was to start pain killers for the abdominal pain, sleeping pills so I could get a decent night’s sleep because as he said, you can fight the pain when you are rested, and we started in with a new battery of tests to determine gallbladder function. After a trip to the ER and several tests later, in October my gallbladder became infected and inflamed, which had to be removed. After surgery I didn’t seem to improve and continued to decline in health. By this time my diet consisted of saltine crackers, soup and oatmeal. The doctor suspected I had developed Sphincter of Oddi Dysfunction, which affects the valves in the biliary tract. The sphincter of oddi is a muscular valve that controls the flow of bile and pancreatic juice through the bile tract (area from the liver, gallbladder and pancreas to the stomach) and flows into the first part of the small intestine. Sphincter of Oddi Dysfunction (SOD) happens when that valve doesn’t relax and causes severe spasms. This causes the bile juices to back up and causes episodes of severe abdominal pain.

Typically, doctors wait 90 days after gallbladder removal to perform an ERCP, which is a type of endoscopy, to measure sphincter pressure. Unfortunately, my body didn’t wait that long and the sphincter valve ruptured on its own sending me to the ER in excruciating pain. The doctor explained that that valve is held together with what appears to be rubber bands and I was feeling each rubber band snapping free. The doctor performed emergency surgery to repair the sphincter valve and pancreatic valve. Recovery went very slowly from the SOD surgery and the upper-right quadrant pain was still present, although not as bad as it was before the surgery. My gastrointestinal symptoms continued on through the spring and in early summer of 2006, my doctor repeated the ERCP to clean out scar tissue he thought was causing the continued pain. Since my GI symptoms failed to improve, he decided to do the capsule endoscopy to test for celiac damage. This procedure required me to swallow what looked like a capsule. There was a tiny camera implanted in the capsule so when I digested it, it took pictures of my digestive system. I also wore a contraption all day that logged the pictures being taken inside of me. I am a technology geek and I have to admit, I thought it was pretty high-tech and very interesting. Although the blood tests did not come back positive, the capsule endoscopy did indicate that I probably did have Celiac Disease or at least I had intestinal damage to support that diagnosis so he determined the best course of action would be to remove all gluten from my diet. Through elimination, we also determined it was best to eliminate lactose and egg yolks as well. Following the gallbladder surgery and Sphincter of Oddi surgery I have not been able to process much fat and by this time I had pretty much eliminated most meat and nuts because they caused too much pain and distress and my body just refused to digest them. With my new diet in hand; a trip or two to a registered dietician, in August 2006 I began my journey into living a fulfilled life without gluten, lactose, egg yolks, raw fruits and vegetables along with a low-fat diet.

To be continued….

Dr. Maureen Ellis, Ph.D.
Business and Information Technologies Education Department
East Carolina University

Thank you Mareen. Maureen has generously offered to share her continued story as time progresses. Check back for Part 2 or sign up for the RSS feed on the right hand column.(this means you will get updates sent to you in case you are not familiar with this feature)      Read Part 1

Tina Turbin

What exactly is celiac disease then? It is an autoimmune disease caused by an allergic reaction to the component of wheat, barley, and rye, called gluten, which can affect the entire body. There are many painful symptoms which are confused for the symptoms of other diseases, and most doctors, uneducated in celiac disease, fail to diagnose it correctly.

Why is it that you and your doctors probably haven’t heard about celiac disease? Although the amount of research on celiac disease is growing, it depends entirely on the generosity of benefactors for its funding. Without these charitable donations, there would be no way to continue this research and the efforts to raise awareness. Out of the estimated fifty autoimmune diseases that have been discovered by doctors, it is the only one for which research isn’t supported by the U.S. government.

Despite the lack of funding, thanks to the hard work of celiac disease advocates, there has been some progress made in the fight to raise awareness. In 2003, an unofficial group of celiac community leaders came together to help persuade Congress to pass a law which would require food labels to include information about allergens. The Food Allergen Labeling and Consumer Protection Act was signed into law on August 3, 2004, greatly helping those who suffer from celiac disease or who are gluten-sensitive to shop for gluten-free groceries. When this was achieved, the need for a permanently established advocacy organization was seen, and this advocacy group became the American Celiac Disease Alliance (ACDA), which continues to this day to represent the celiac community to Congress.

Thus, strides have certainly been made in respect to helping the celiac community, but this isn’t good enough. After all, out of the three million Americans who are estimated to have the disease, only about three out of every hundred of them have been diagnosed. I am one of the lucky three who discovered the cause of the physical, and emotional, agony sufferers of celiac disease go through. I spent years going from doctor to doctor, getting test after test, trying a variety of suggested solutions, but with no answers and no relief. That’s when I began my own research. It was a long, hard road, and I’m determined that no one else have to follow it—if they’re even able to.

That’s why I support centers such as Columbia University’s Celiac Disease Center and the ACDA, but I’ll tell you something—they’re going to need more than just my own support. They need the advocacy and financial support of the government in order to end the suffering of three million of its citizens.

Sometimes our immune system breaks down and does not operate as it should do to a variety of reasons and the body starts attacking itself, or attacking normally beneficial substances in the body. Our immune system is to ensure that harmful substances are cleared from the body while the ‘good’ necessary tissues and organs are left alone. Let me share an Article I feel we all may benefit from: enzymesstuff.com

“The idea behind using enzyme therapy to correct the autoimmune function is that you are not just treating symptoms, you are helping to re-establish the correct regulation and support of the immune system. “

No one is completely sure what causes particular autoimmune diseases although a mixture of genetics, environment, and maybe pathogens is involved. Which symptoms actually appear may depend on a combination of the individual’s environment, experiences, and biochemistry, and which major organs or parts of the body are affected.

Currently, no cures for most autoimmune diseases exist. However, many good treatments are available that allow you to live around the condition, have a good life, and prevent the situation from worsening. A two-sided approach includes adding supplements to keep the immune system strong and avoiding things that stress it. Digestive enzymes, particularly proteases, may be quite helpful in improving auto-immune system related conditions.

A key source of problems with autoimmune conditions is inflammation, which causes much of the associated pain. If inflammation persists, tissue is destroyed. Managing and controlling inflammation goes a long way towards limiting the damage caused by an autoimmune condition. Proteases are very effective for controlling inflammation.

One of the problems with medications commonly used for autoimmune conditions is they often suppress the immune system. The thinking is that since the immune system is waging the attack on the body, then suppressing the immune system reduces the problem. However, slowing or suppressing the immune system will also prevent the body from its natural ability to protect itself from invaders. Now you are left open to developing other illnesses. This is one of the major blessings of using a natural substance such as digestive enzymes.

Enzymes are very effective at building up the immune system while at the same time decreasing inflammation, all with none of the side-effects of many medications. Enzyme therapy has an excellent track record in the treatment of many types of autoimmune diseases.

A substantial amount of research has found that there are compounds called circulating immune complexes which build up in auto-immune conditions. Under normal healthy conditions, these complexes are eliminated from the body immediately. Where there system isn’t working properly, these complexes persist and may settle in different parts of the body. Where they settle may be different in different conditions. For example, in arthritis, these complexes tend to settle in the joints. Or in fibromyalgia it may be the tissue surrounding the joints. In Multiple Sclerosis, it may be the muscle or nerve tissue. When this happens, the complexes can cause inflammation and tissue damage. These complexes can also contribute to cancers. Testing shows many people with autoimmune diseases have a much higher number of these immune complexes, either lodged in tissue, in circulation, or both.

Research since the 1970s has shown that eliminating these immune complexes improves many conditions including the ones listed here. Enzymes are one way to eliminate these all-important immune complexes. Certain mixtures of hydrolytic enzymes, including proteases, lipases, and amylases have reduced the number of circulating immune complexes in past studies (Stauder 1990; Stauder et al 1989; Ransberger et al 1988; Targoni, Tary-Lehmann, and Lehmann 1999). Enzymes work by breaking up the harmful complexes and activating the macrophages, which gobble up and destroy the intruders. This ends the vicious cycle that leads to deterioration and many chronic disorders.

Some German clinical studies that immune complex dysfunctions might be effectively relieved with enzymes which target the formation of the immune complexes. There are very encouraging results with Crohn’s disease or ulcerative colitis. This is very good because such conditions have been hard to treat with known medicines. It is believed that the chronic inflammation involved in these conditions is triggered by immune complexes being deposited in the intestinal tissue. http://www.enzymestuff.com

Fiasse, R., Lurhuma, A.Z., Cambiaso, C.L., Masson, P.L., and Dive, C. (1978) ‘Circulating immune complexes and disease activity in Crohn’s disease.’ Gut 19:611–617.

Hodgson, H.J.F., Potter, B.J., and Jewell, D.P. (1977) ‘Immune complexes in ulcerative colitis and Crohn’s disease.’ Clinical and Experimental Immunology 29:187–196.

Kre, I., Kojecky, Z., Matouskova, I., and Benysek, L. (1980) ‘Crohn’s disease, serum immunodepressive factors, and circulating immune complexes.’ Bollettino Dell’Istituto Sieroterapico Milanese 59:619–624.

I have tried the Oats that are from dedicated facilities and I am one of those that do not do well with oats despite all the literature I have read, researched and tried. I get aches and stomach troubles.  

I am thrilled for those that do tolerate the oats. I sure wish I could as I long for those days with my hot oat meal in the morning, with melted butter all over the top, and I mean all over the top. My spoon had to dive through the melted butter to even get to the oats. Yes, I love butter, coconut oil etc.

Anyhow, being on a GF diet has it care and concerns for the actual dieter, and this does need to be looked at. The grains we are allowed to have for the most part are not too terribly loaded with fiber, in fact they can be rather binding. They do not help the intestinal tract to move, which is called peristalsis. This moves the food through the colon into the rectum.

We need to eat plenty of fruits and vegetables yet when one is healing still form a newly diagnosis of gluten intolerance or celiac disease, our small intestinal lining is sensitive and needs to heal. The unfortunate part of this diagnosis is that often there are other effects in or on the body form the years of not being diagnosed correctly. Hence you nay have a terribly sensitive tummy, irritated bowels, aches in the joints, skin troubles etc. Some other foods may cause irritation and even an increase in vegetables and fruits may irritate your body somehow.

Be sure to work with someone who understands your diagnosis that you feel comfortable with and trust and the healing process can take place a bit smoother.

Just do not go out and load up on a bunch of GF baked goods and expect to feel better overnight. The fiber content of most of the GF baked goods on market do not have much fiber and can cause you to be a bit constipated.

Tina Turbin

Key Concepts

• Celiac disease (CD) is an autoimmune disorder triggered by ingestion of gluten, a major protein in wheat, or of related proteins in other grains.
• Research into the root causes indicates that the disorder develops when a person exposed to gluten also has a genetic susceptibility to CD and an unusually permeable intestinal wall.
• Surprisingly, essentially the same trio—an environmental trigger, a genetic susceptibility and a “leaky gut”—seems to underlie other autoimmune disorders as well. This finding raises the possibility that new treatments for CD may also ameliorate other conditions.

My vote for the most important scientific revolution of all time would trace back 10,000 years ago to the Middle East, when people first noticed that new plants arise from seeds falling to the ground from other plants—a realization that led to the birth of agriculture. Before that observation, the human race had based its diet on fruits, nuts, tubers and occasional meats. People had to move to where their food happened to be, putting them at the mercy of events and making long-term settlements impossible.

Once humans uncovered the secret of seeds, they quickly learned to domesticate crops, ultimately crossbreeding different grass plants to create such staple grains as wheat, rye and barley, which were nutritious, versatile, storable, and valuable for trade. For the first time, people were able to abandon the nomadic life and build cities. It is no coincidence that the first agricultural areas also became “cradles of civilization.”

This advancement, however, came at a dear price: the emergence of an illness now known as celiac disease (CD), which is triggered by ingesting a protein in wheat called gluten or eating similar proteins in rye and barley. Gluten and its relatives had previously been absent from the human diet. But once grains began fueling the growth of stable communities, the proteins undoubtedly began killing people (often children) whose bodies reacted abnormally to them. Eating such proteins repeatedly would have eventually rendered sensitive individuals unable to properly absorb nutrients from food. Victims would also have come to suffer from recurrent abdominal pain and diarrhea and to display the emaciated bodies and swollen bellies of starving people. Impaired nutrition and a spectrum of other complications would have made their lives relatively short and miserable.

If these deaths were noticed at the time, the cause would have been a mystery. Over the past 20 years, however, scientists have pieced together a detailed understanding of CD. They now know that it is an autoimmune disorder, in which the immune system attacks the body’s own tissues. And they know that the disease arises not only from exposure to gluten and its ilk but from a combination of factors, including predisposing genes and abnormalities in the structure of the small intestine.

What is more, CD provides an illuminating example of the way such a triad—an environmental trigger, susceptibility genes and a gut abnormality—may play a role in many autoimmune disorders. Research into CD has thus suggested new types of treatment not only for the disease itself but also for various other autoimmune conditions, such as type 1 diabetes, multiple sclerosis and rheumatoid arthritis.

Early Insights
After the advent of agriculture, thousands of years passed before instances of seemingly well-fed but undernourished children were documented. CD acquired a name in the first century A.D., when Aretaeus of Cappadocia, a Greek physician, reported the first scientific description, calling it koiliakos, after the Greek word for “abdomen,” koelia. British physician Samuel Gee is credited as the modern father of CD. In a 1887 lecture he described it as “a kind of chronic indigestion which is met with in persons of all ages, yet is especially apt to affect children between one and five years old.” He even correctly surmised that “errors in diet may perhaps be a cause.” As clever as Gee obviously was, the true nature of the disease escaped even him, as was clear from his dietary prescription: he suggested feeding these children thinly sliced bread, toasted on both sides.

Identification of gluten as the trigger occurred after World War II, when Dutch pediatrician Willem-Karel Dicke noticed that a war-related shortage of bread in the Netherlands led to a significant drop in the death rate among children affected by CD—from greater than 35 percent to essentially zero. He also reported that once wheat was again available after the conflict, the mortality rate soared to previous levels. Following up on Dicke’s observation, other scientists looked at the different components of wheat, discovering that the major protein in that grain, gluten, was the culprit. From the August 2009 Scientific American Magazine

By Alessio Fasano