Celiac Disease and A Gluten Free Lifestyle [Interview][Transcript]

Dr_Alessio_Fasano_Celiac_DiseaseGuest: Dr. Alessio Fasano
Presenter: Neal Howard
Guest Bio: Dr Fasano will visit Sydney, Australia as a speaker at the 4th BioCeuticals Research Symposium (22-24 April, 2016) to educate Australian health professionals on celiac disease and awareness of Celiac disease as a growing public health problem. Dr Fasano is the author of Gluten Freedom, which examines the groundbreaking roadmap to a gluten-free lifestyle.

Segment overview: Dr. Alessio Fasano, MD, discusses Celiac Disease and its symptoms.

Transcription

Health Professional Radio – Celiac Disease

Neal Howard: Hello and welcome to Health Professional Radio. I’m your host Neal Howard, thank you for joining us today. Our guest in studio today is Dr. Alessio Fasano, he is going to be one of the key speakers at the 4th BioCeuticals Research Symposium entitled Revolutionary Strategies for Complex Diseases, where he’ll highlight the latest advances in nutritional and integrative medicine, going to be covering a wide range of fields. He is with us today to talk about “gut health.” He’s also the author of “Gluten Freedom” which examines the roadmap to a gluten free lifestyle. Welcome to Health Professional Radio Dr. Alessio Fasano.

Dr. Alessio Fasano: Thank you for having me on the show Neal.

N: The upcoming 4th BioCeuticals Research Symposium going on in Australia the 22nd through the 24th of April of this year. Is this the first time that you’ve attended this symposium?

F: Yes, indeed it will be my first time.

N: Now you’re going to be talking to Australian health professionals about the role of gut permeability and autoimmunity among other things. Talk about the celiac disease, gut permeability and how it relates to what you’ll be talking about in Australia?

F: Sure, Celiac disease is an interesting model about immunity because it has some peculiarities that make this one of a kind when you compare it to other auto immune diseases like diabetes and multiple sclerosis, rheumatoid arthritis, and so on. And the rest are the same, you have to be genetically predisposed but you have already one specific peculiarity in there. Some of the genes that are necessary to develop celiac disease are present in almost in the totality of people with celiac disease that’s not typical when we see in other autoimmune disease, to the point that if you don’t have those gene you can’t develop the disease. The second ingredient of the recipe to develop autoimmunity is an environmental trigger that is mismanaged by the immune system because of your genetic makeup. So the immune system is there to defend you when you’re exposed to enemies, deploy weaponry to get rid of these enemies and now the immunity rather than to fight against the enemy you start to fight against your own body. The problem is for the vast majority of the autoimmune diseases we don’t know what’s the trigger, while for celiac disease, and we know what is the trigger that is gluten, and as a matter of fact because we have this kind of information celiac disease is the only autoimmune disease for which we have a treat to them because you go gluten free and the symptoms will go away. And third ingredient of this recipe that we learn to celiac disease is that you have to have a breach of the barrier of intestines, so in other words you have an increased gut permeability. And that’s something that we learn by studying celiac disease by the … system and that’s now seems to be a common knowledge with many other autoimmune diseases.

N: Most of our listeners are healthcare professionals and are familiar with what gluten is. But for those of us who don’t know exactly what gluten is, we hear a lot about it. What exactly is gluten?

F: So gluten is a protein, also in this case one of a kind protein. And the most abundant one is present to some grains like wheat, barley and rye, is the key protein elements in these grains, that gives some…characterization to these grains in terms of palatability and what you can do with these grains, because of the elasticity that this protein gives to the product that are made by these grains like pasta, breads, cookies and beer and so on and so forth. Being the most abundant protein and therefore are seemingly well-presented in terms of the component of these grains, it turns out also that is a peculiar protein because contrary to many other proteins that we ingest with foods stuff, we cannot dismantle completely this protein single blocks amino acid. So in others words our digestive enzymes the best they can do is to cut gluten in pieces what we call peptides, but not in single elements like amino acids. And when you don’t digest completely protein, it then make the journey thru the intestine, virus comes in, and these are the ones that we see as enemies. So the fact that we are not able to completely digest gluten and makes this a very risky protein if you’re genetically predisposed to develop a problem. Now I know there is a lot of discussion about gluten and the gluten-free diet and who should, who should not go on a gluten-free diet. And again there are extremes in the very heated and far to be settled debates, some people they said that nobody should be on a gluten-free diet, because this is a fact and the other extremes said everybody should go to gluten-free diet because otherwise we all would get in trouble, truth probably is somewhere in the middle.

N: Okay. So that is my next question, I’ll ask the author of “Gluten Freedom,” a book that examines the ground breaking roadmap to a gluten-free lifestyle. I’m sure that you explain who would benefit from such a diet?

F: Oh absolutely, I mean there are clear cuts in other words people that undisputedly will benefit to gluten-free diet and everybody would agree with that. These are the people they have medical necessity, they go gluten-free because if they don’t, they get sick. There is a general agreement that for example people with celiac disease indeed knowing that gluten is the culprit of the disease needs to go on a gluten-free diet to stay healthy. And as I was explaining before knowing the gluten is the instigator of the autoimmune process that characterize celiac disease and knowing that when you go gluten-free the autoimmune assault of the intestine is gone, there is no discussion that people with celiac disease needs to go on a gluten-free diet. There’s some discussion that people that with allergy needs to go on a gluten-free diet, more of a discussion is a third a category of people that have been recently identified that people they’re affected by what we call “gluten sensitivity” or on gluten sensitivity, how many they are if they should go strictly gluten-free should not and so on and so forth.

N: What are some of the symptoms that one would look for seemingly that they should go gluten free?

F: That’s right. So this is … challenge in part of the story in the past when it was originally described, because this is a damaged intestinal disease, we focus completely on GI symptoms so diarrhea, abdominal pain, bloating, weight loss, failure to having kids, those were land mark of the disease. And then of course when you say clear understanding why you have the symptoms, is if your intestine is destroyed. With these more sophisticated tools to diagnose people with celiac disease, we really realize is that while the inflammation’s starts in the gut, it really can spread in any time and part of the body to any tissue, or organ can be affected. So the answer to your question is vague unfortunately, because you can really have an unbelievable number of signs and symptoms that do not indicate that the problems is the gut, such as chronic fatigue, anemia, joint pain, problem that involves your brain and behavior from short memory loss all the way to schizophrenia, infertility, osteoporosis, and the list goes on and on and on, problems with skin with dermatitis herpetiformis. So is truly a clinical… it’s very difficult to really to answer your question what kind of symptoms I look after to consider that I have celiac disease and therefore I’ve been screened and eventually…with gluten-free diet.

N: Our guest in studio today has been Dr. Alessio Fasano, going to be visiting Sydney Australia to speak with the 4th BioCeuticals Research Symposium, the April 22nd through the 24th to educate Australian health professional on celiac disease and the awareness of celiac disease as a public health problem. And Dr. Fasano says that treating patients for celiac disease could provide clues to treating symptoms of other autoimmune disorders. It’s been great having you here with us today Dr. Fasano.

F: Thank you for having me.

N: Thank you. Transcripts and audio of this program are available at healthprofessionalradio.com.au and also at hpr.fm and you can subscribe to our podcast on iTunes.