The phrase “gluten intolerant” is a rather nebulous term which is why I try to avoid using it. I prefer to use ‘gluten sensitivity’. The sub-groups of gluten sensitivity are: gluten sensitive enteropathy (otherwise known as celiac disease); non-celiac gluten sensitivity; neuropathic gluten sensitivity, etc.
Gluten sensitivity is the term recommended by the world renowned celiac researcher, Dr. Michael N. Marsh. The terminology I advocate is congruent with Dr. Marsh’s assertions and it provides some clarity, as it often identifies specific sites of damage induced by gluten, distinguishes between some subgroups, and allows even the novice to
accurately interpret some discussions of these topics.
The varying opinions on another’s biopsies may have be driven by just how familiar or unfamiliar physicians are with the Marsh system for categorizing intestinal damage, which was developed by the same Dr. Michael Marsh mentioned above. The Marsh system is gradually being adopted throughout most of the industrialized world, as older pathologists and gastroenterologists advance their understanding, and the younger ones usually learn about the Marsh system during their specialization training.
Of course, the terminology I recommend also makes it very clear that there are a number of types of gluten-induced damage to various body systems. Dr. Rodney Ford, on the other hand, has offered the term gluten syndrome’ to incorporate the various groups of gluten sensitivities into one group. I also subscribe to that choice of terminology. Careful word choices in this regard are, I think, critical to understanding the broader field of gluten sensitivity, and that celiac disease is just one sub-set of a rather large and growing continuum of illnesses that require a life-long gluten free diet.
Celiac disease has long been considered the most serious of this spectrum and other gluten sensitivities were considered “lesser” ailments. However, Anderson et al recently published findings that suggest that non-celiac gluten sensitivity may more frequently lead to serious illness or death than celiac disease (1). If confirmed by
further research, we may need to revise our opinions regarding where celiac disease falls on the gluten sensitive spectrum.
I hope my comments serve to clarify this issue for many.
Ron Hoggan, Ed. D.
co-author: Dangerous Grains ISBN: 978158333-129-3 www.dangerousgrains.com ,author: The Iron Edge: a complete guide for meeting your iron needs ISBN: 978-0-9736284-4-9 , author: Smarten Up! ISBN: 978-0-9736284-3-2 www.smartenup.info
1. Anderson LA, McMillan SA, Watson RG, Monaghan P, Gavin AT, Fox C,
Murray LJ. Malignancy and mortality in a population-based cohort of
patients with coeliac disease or “gluten sensitivity”. World J
Gastroenterol. 2007 Jan 7;13(1):146-51.
From our home to yours, Tina Turbin.