Celiac disease (CD) is an autoimmune condition affecting the small intestine. It is also spelt  coeliac disease, sometimes called gluten-sensitive enteropathy, and can be seen in a particular variation called celiac sprue. Gluten is found in a variety of grains, including wheat, rye, oats and barley, easily remembered using the acronym WROB, which is quite appropriate since untreated celiac will rob one's health.

In susceptible individuals, gluten triggers the production of antibodies that damage the cells lining the small bowel, causing inflammation and a decrease in the nutrient absorptive capacity. The resulting malabsorption of protein, fats, vitamins, and minerals can lead to stunted growth in children, thinning of the bones (osteoporosis), anemia, weight loss, higher risk of scoliosis, tendency to develop allergies and more. CD usually appears in childhood, manifesting as symptoms such as diarrhea, abdominal pain, and bloating. Untreated, it increases the risk of developing certain types of cancer, including intestinal lymphoma, a common advanced complcation, and colon cancer.

It is also important to recognize the little-talked about issue of psychological wellbeing. People affected by CD tend to have increased challenges here and appear to experience increased risk of developing a range of disorders.

Until relatively recently mainstream medicine has largely ignored CD or tended to downplay its significance. This is most likely due to there being no medical treatment for the disease. Successful treatment of CD relies on the complete avoidance of gluten-containing foods. A diet of gluten abstinence is quite difficult to achieve at the required 100 percent exclusion level and it typically takes quite some time for this to be achieved and then some time for healing of the bowel to be complete.

Most breads, cakes, biscuits, crackers, pasta, gravies, pies, and a host of other processed foods can be easily identified as foods to avoid. More difficult are such things as modified food starch, malt flavoring and many other fine-print ingredients that actually contain gluten. Corn, rice, quinoa, amaranth, and buckwheat do not contain gluten and can be eaten by people with celiac disease, but many discover that one or more on this list also cause digestive symptoms, probably due to the damage caused during gluten consumption.

Unfortunately, many health professionals who should know better, are giving quite unsafe advice to celiacs (the term for those with CD). For example Kimberly Beauchamp, ND, recently wrote in Healthnotes: "While oats contain some gluten, most people with celiac disease appear to tolerate oats."

It gets worse. In the January 1996 Harvard Health Letter I found this:

Q I have celiac disease and have to avoid foods that contain wheat, rye, and barley. Is it true that I can eat oatmeal, after all?

A Results from a recent Finnish study indicate that people with celiac disease, "either newly diagnosed or in remission, can almost certainly eat oats," says Stephen E. Goldfinger, editor in chief of the Harvard Health Letter and a gastroenterologist at Massachusetts General Hospital.

In celiac disease (also called celiac sprue), the lining of the small intestine is damaged by a gluten protein called gliadin, which is found in wheat, rye, and barley. "Doctors have traditionally erred on the side of caution and advised people with celiac disease to avoid oats as well," says Dr. Goldfinger. However, recent analyses show that oats do not contain gliadin.

In the Finnish study, which was published in the New England Journal of Medicine last October, 52 people with celiac disease in remission and 40 patients who had just been diagnosed followed a gluten-free diet. Half the participants also ate 30-70 g of oats a day (40 g equals one serving of cooked oatmeal). Those who ate oats reported feeling fine, and biopsies showed no damage to the lining of the small intestine.

"Go ahead and add small amounts of oats to your diet," advises Dr. Goldfinger. "You'll be the first to know if your bowel can't tolerate it."

This is foolish and dangerous advice. It is typical of the disgraceful approach taken to CD by the orthodox medical profession. For example, while doctors usually miss the diagnosis as it seems to fall in their "blind-spot", when they do actually suspect a patient has CD, they will arrange a biopsy of the small intestinal wall for confirmation.

This reflects two significant problems. First their overuse of technological tools and misguided reliance on laboratory findings over history-taking, examination and treatment responsiveness. They put so much faith in their expensive, invasive and "scientific" approach they cause real problems for people when the labs or surgeons get it wrong (as they often do).

The second problem is an ethical one. Such doctors have no hesitation in sending suspected celiacs for biopsies. To help ensure the result will be clear, they encourage patients to consume plenty of gluten for some time before the procedure to ensure damage will be easily detected! Whatever happened to: first, do no harm?

I will end Part 1 here and continue in Part 2 with a brief discussion of what gluten is and where it is found. I will also briefly mention foods to eat and ones to avoid. In the meantime remember, no wheat, rye, oats or barley containing foods.