Video Capsule May Diagnose Coeliac Disease

 

New York - A new device - video capsule enteroscopy (VCE) - accurately detects intestinal atrophy in patients suspected to have coeliac disease, according to a report in the American Journal of Gastroenterology.

The diagnosis of coeliac disease currently requires upper GI endoscopy with multiple biopsies to identify the characteristic irregularities in the mucus tissue of the small bowel, the authors explain. GI endoscopy is a procedure in which a tube is inserted into the digestive tract. The tube is equipped with a small camera to visualise abnormal tissues, which can be biopsied or removed.

Coeliac disease is a genetic disorder in which the body's immune system damages the small intestine in responses to foods containing gluten, a protein in wheat, rye and barley.

Coeliac disease may cause a variety of symptoms. Diarrhoea, abdominal pain, irritability and depression are common, but some people may have no symptoms. Treatment for the condition is a gluten-free diet.

Dr Roberto de Franchis from the University of Milan, Italy and associates tested the performance of VCE in 43 patients with signs or symptoms suggestive of coeliac disease and compared the results to those obtained by conventional upper GI endoscopy with biopsies.

Of 32 patients found to have abnormal tissue, 28 were diagnosed with coeliac disease by capsule endoscopy, yielding a sensitivity of 87,5 percent.

VCE had 90,9 percent specificity, 96,5 percent positive predictive value, 71,4 percent negative predictive value for diagnosing coeliac disease.

"The recently introduced VCE may be a valid alternative to... biopsy in this patient population, since it provides high-quality images of the small bowel mucosa," the investigators conclude.

"Furthermore, it is minimally invasive, which may improve patient acceptance, and it allows exploration of the whole small intestine, which may lead to the identification of (abnormal tissue) beyond the segments reached by upper GI endoscopy."

They add that the findings "await confirmation in a larger study".

SOURCE: American Journal of Gastroenterology, August, 2007.

Letter in Belfast Telegraph

 

The following letter appeared in the Belfast Telegraph

Coeliac sufferers in need of understanding

Wednesday, August 01, 2007

As a coeliac, I read with more than passing interest Dr Dunn's statement that coeliacs are entitled to free prescriptions and free food (Belfast Telegraph, July 6).
While as the Coeliac Society UK noted that he was wrong on both counts, what is more worrying is that he is the chairman of the BMA GP committee.
What chance do people have of 1, being diagnosed, and 2, getting the help they need if the top GP is so ill informed!
How much does he know about this unbelievably difficult disease and its consequences and the lifelong adherence to a diet which is practically non existent in the outside world?
I expect he knows all about vegetarians (which is a lifestyle choice!), as it seems does every manufacturer, but let him try a gluten free diet (coeliac is a disease) for a week and see how he fares.
Maybe then coeliacs will get the help they need and deserve.
Appalled Coeliac

Bio-Fuel

 

I read this article in the Sindie on Sunday and I wonder if this is going to cause problems for coeliacs as it appears that the US is going to turn an awful lot of their maize over to the production of useless biofuel. So if there is a shortage of maize, does this mean that a lot of products will substitute wheat for maize.

I shall be watching out, as all too often food processors, go for the cheapest rather than the best option.

This is my reply to the Sindie.

Rupert Cornwell in his column on Sunday, talked eloquently about the rush to biofuel using maize in the United States and how it was not good for the world in general, for the environment, for the production and price of food and everybody except those addicted to their overweight and underefficient vehicles.

I am worried about another consequence of biofuel.

Like 1-in-100 of the population of the UK, I am a coeliac, which means I’m allergic to the gluten in wheat, barley and rye. So that means I can’t eat bread, beer or pasta. But I can eat a wide and varied diet that keeps me healthy.

Food manufacturers and processors, especially in the UK, have over the last few years made great strides in removing gluten from their products, mainly by the use of maize starch. Because of biofuel, they will now find that the price of this basic ingredient will rise steeply. So will revert to cheaper gluten-based alternatives, thus limiting the diet for many of us?

I hope not.

Disease...?

 

I always say I’m a coeliac, as disease is very negative. A lot of people describe themselves as asthmatics for example.

If anything we have a non-disease, as in most cases, the symptoms can be completely got rid of, by a simple diet.

Son Julia Hotel, Majorca

 

We stayed at this hotel in Majorca for my sixtieth.

They understood what to do and a good gluten-free few days was had by all.

I should say that the hotel is not cheap, but the grounds, pool etc are magnificent. Note too, that we’ve spent New Year on the island and were able to swim outside, as it’s not unknown for the temperature to be 20 degrees. A double room in October was about 184 Euros a night upwards. Suites were up to 700 Euros.

They seem to be part of the Stein Group of hotels and I’ve e-mailed them to see if all hotels have the same gluten-free policy.

As an aside, I noticed that at Palma Airport, all of the prepared salads were properly labelled and it was obvious which contained gluten, as it’s the same in one form of Spanish.

Pringles Rice Crisps

 

This is the correspondence, I've had over Pringles Rice Infusions.

The first is my letter to Pringles in Belguim. Yes, the Customer Service Department where you write to is in Belguim.

My local supermarket is Waitrose in Newmarket.

Today they had a promotion on your new rice-flavoured Pringles.

Now I should say at this point that I am a coeliac and therefore can’t eat wheat, barley or rye.

So I asked the demonstrator, if your new product was suitable for me and he said no. (10/10 for him!) So we had a very good look and could just see that there was a very small note that said the product contained wheat starch.

So you put rice all over the product and then say in very small print that the product contains wheat.

Where is the mark that says that your product is suitable or not-suitable for coeliacs? Nowhere!

I suggest that you look at your competitors like Kettle or Walkers.

I shall be reporting your product to Trading Standards because of the misleading packaging and the fact that it is not clearly labelled as unsuitable for coeliacs.

If you want to see the full letter I wrote, it's here as a pdf file.

I don't think that their reply was very helpful, but that is not for me to judge. Just read their full reply.

As I said I would I wrote to Trading Standards when I received the unsatifactory reply.

I am enclosing some correspondence that I have had with Pringles concerning their new Rice Infusions.

As a coeliac, I thought that here must be something that I can add to my limited diet. I am a coeliac, which does get a bit difficult, when you are away from home and can’t cook your own fresh food.

The packaging emphasises the rice, but it is only 26%. The major component is wheat starch, from which most of the gluten has been removed to make the product meet the CODEX level. For many coeliacs including myself, this is not good enough and eating some of this product would cause severe diarrhoea and other problems.

The packaging on this product must be changed so that it says “Unsuitable for Coeliacs”. Walkers, Kettle and other crisp manufacturers do this, so why not Proctor and Gamble? It is just like Cadburys and other chocolate manufacturers saying “May contain nuts”.

But they are unrepentant.

I should say that Waitrose have behaved correctly and warned me against the product.

Again if you want to see the full letter, just click here.

I also wrote to Procter and Gamble, returning their two pound voucher.

Thank you for your totally inadequate reply.

You say I got the wrong information in-store. I did not. Waitrose obviously care a lot about their customers and don’t want them to suffer adverse reactions to the products they sell.

Rice Infusions may be gluten free according to the regulations, but they are not gluten free, which as my wife who is a barrister says, is totally without gluten.

I am not a supersensitive coeliac, but I am sensitive to small amounts of gluten in such things as wheat starch and glucose. For instance, I can’t use most normal cough mixtures and Boots have advised me the ones that use real sugar instead of wheat glucose.

So your product should say that it is “Unsuitable for coeliacs”, just like most of the other snack manufacturers, such as Walkers and Kettle, do in similar circumstances.

I am returning the voucher as I have no use for it.

The full letter is here.

I shall update this as the correspondence develops.

Gravetye Manor

 

We went here before we went off to Majorca for my sixtieth birthday on the 16th.

It was very good and they even produced some gluten-free bread for the nibbles. And that was without warning.

But we couldn't make any allowance for the awful weather.

Nail Biting

 

This news story is about a cure for nail biting.

Funny, but I stopped biting mine after over 50 years, when I went on a gluten-free diet.

J D Wetherspoon

 

I complained to Wetherspoons about the menu in their airport cafe at Stansted.

This was the reply.

I am sorry to hear of your disappointment. I have enclosed the following link to our website that will enable you to search our current menu for food that may be suitable for you.

http://www.jdwetherspoon.co.uk/food/

Please select the option for 'Food Facts' and follow the instructions on screen. We have also recently added a logo onto our menu to show which meals are gluten free.

In reply to your comments about the available food at the airport pubs, I will be passing these to the Catering Department for consideration in the future.

I trust that this will be of assistance to you and thank you for contacting us.

I shall be looking for the logo on the menus.

Prewett's Chocolate Biscuits

 

I’ve just tried out some of these biscuits. They seem quite new and are available in Tescos and Waitrose.

They were pretty good for gluten-free chocolate biscuits.

We also got some GF Jaffa cakes in Waitrose this morning. They were from Baker’s Delight.

Warning - Pringles New Rice Crisps

 

These were on special offer with Waitrose this morning. They looked like they might be gluten-free.

But they also had an old retainer, demonstrating and giving out tasters, so I asked him if they were gluten-free.

He said sadly no, but the fact is buried in the very much small print on the packet. In fact, I suspect they are even less gluten-free than the normal Pringle crisps.

So I shall be sending this to Pringle as I think that saying the product is rice-based (only 26%) and then not saying it’s gluten-free is almost fraud.

So it’s full marks to the demonstrator at Waitrose and nil points to Pringle.

Letter to The Times

 

This letter was published in The Times today.

Sir, Since the recent floods we have had to make do with bottled water. I have noticed that some bottles contain water that is said to be “gluten free”. So far I have not discovered any bottled water that “may contain gluten”.
DR DAVID STEVENS, Cheltenham, Glos

Visiting London

 

This is based on an e-mail I wrote to a guy in the States, who's visiting London in August.

He'd queried the cost of food in London.

It wouldn't be that much for a fish. We ate in L'Escargot on Saturday and the food was about £23 each for two big courses. My wife actually paid £15 as she stuck to the set menu. But L'Escargot is expensive.

If you have your own flat, you'll be fine. Pimlico is not an area of London I know well, but you are very close to Tate Britain, which is an excellent gallery. It's free too! All the big museums are.

How long are you staying? The reason is that you can get some pretty good Tube/bus tickets or buy an Oyster Card.

This site explains it all.

I should say that I'm sixty next month and not short of a bob or two, but I always use public transport in central London. Even late at night, as it's all very safe. In many cases use the buses, which are easy with an Oyster as you just touch the reader and walk in.

You also have to remember that given good weather, London is not an expensive city. You can roam a long way on public transport and there is much outside to see. Just walking along the river from Pimlico to the city is a free show, unlike any other city in the world.

If you like the theatre you never need to pay full price on say a Monday or a Tuesday. Just go to the half price booth in Leicester Square. I've seen some very good shows that way. In fact last weekend we went to a small theatre in Soho and paid £7.50 for the ticket as against the £30 plus you'd pay full price in a top theatre.

So come and enjoy my city.

Top ten things to visit, in no particular order :-

1. Hampstead Village and the Heath - Northern Line and then walk down to Cafe Mozart on Swains Lane, bus back to central London
2. Greenwich - Take the Docklands Light Railway from Bank through the city
3. The City - Just walk around it.
4. British Museum - Free and the best roof in the world - See the Hoxne Hoard.
5. Trafalgar Square and National Gallery - Whistlejacket
6. Tate Modern - What to do with an old power station
7. London Eye - That will cost you a bit but worth it.
8. Regents Park and Canal - Walk the Canal from the Park to Kings Cross
9. North London Line - Take the train across the top of London and see all the development of Eurostar at St. Pancras
10. Crossness Pumping Station - Difficult to get to, but the four largest beam engines in the world

Hope all this helps.