Digestive Disease Week
Digestive diseases are acute or chronic conditions involving the gastrointestinal tract, liver, pancreas, and gallbladder. They range from autoimmune diseases like celiac and Crohn’s to pancreatic and liver cancers, Barrett’s esophagus, and irritable bowel syndrome (IBS).
The May 2019 DDW Conference in San Diego, California supported the largest international gathering of top physicians, researchers, and industry leaders in the fields of gastroenterology, endoscopy, hepatology, and gastrointestinal surgery. They discussed advancements in autoimmune and other diseases related to the gastrointestinal system, as well as what the future holds for diagnosis and treatment of these types of conditions.
- A disruption in the immune system creates a disruption in the gut microbiome, and vice versa. This affects the kinds of chemicals microbes produce, communication between neurotransmitters and other cells, and a host of other critical functions carried out by the microbiome.
Gene Microbe Interactions in Asthma & Allergy: What is the Role of Environmental Microbial Exposure, Jack Gilbert
- The mycobiome (fungal community of microbes) is associated with Candida overgrowth and decreased diversity, and can influence the body’s immune system and inflammatory responses. The mycobiome is an area that needs more study, since the focus in recent years has been on the microbiome (bacterial community of microbes).
Immunity to Fungal Microbiota in IBD, Iliyan Iliev
- Non-celiac gluten sensitivity (NCGS) has been linked to IBS and other functional gut diseases. Other components in wheat like ATIs (amylase trypsin inhibitors), WGAs (wheat germ agglutenins) and FODMAPs (a collection of sugars found in some fruits, vegetables, legumes, grains, and dairy) could also explain gluten sensitivity.
Nonceliac Wheat (Gluten) Sensitivity, Anupam Rej and David Sanders
- There are both pros and cons for screening the entire population for celiac disease
- Can be an issue with asymptomatic patients who’ve been diagnosed and adopted the gluten-free diet. They start to notice reactions to gluten, leading to feelings of frustration.
- Even our best tests for celiac disease are not 100% accurate; there are a lot of false positives.
- Screening early can prevent further complications and development of other autoimmune diseases.
- HLA genetic testing at birth would eliminate large portion of population from needing screening in the future.
- Ideal would be to combine celiac screening with other autoimmune diseases to prevent consequences of untreated conditions.
The Case Against Screening for Celiac Disease, Edwin Liu & Benjamin Lebwohl
- Check with your doctor before taking gluten out of your diet, to allow for the right diagnosis. There are many instances of patients starting a gluten-free diet because they feel gluten may be an issue, then getting a biopsy to check for celiac disease. The results show no signs of disease, so their doctors cannot diagnose them with either celiac, gluten sensitivity, or a functional gut disorder affected by gluten ingestion. The gluten-free diet is life-long for celiac patients, however, that may not be the case for gluten sensitive individuals, so it’s important to get a proper diagnosis.
Incidence and Prevalence of Self-Reported Non-Celiac Wheat Sensitivity and Gluten Avoidance in a Longitudinal Australian Cohort, Marjorie Walker