Stanford pediatric gastroenterologist responds to your questions on celiac disease

Dr Alister George, MD on how to find a good gastroenterologist

They are high in protein, and are even thought to help maintain steady insulin levels. The working idea is that the biochemical nature of oats is gluten-free, but the manufacturing process of oats contaminates it with a common cereal protein called prolamins , which are found in wheat, barley and rye containing seeds that celiac patients have to avoid. One group of investigators analyzed 134 oat grains from various manufacturers in the U.S., Canada, and Europe, and they found that only 25 samples were uncontaminated by prolamins, and the majority of samples tested exceeded the threshold for what would be considered gluten-free. Unfortunately, results from clinical studies have been mixed. Also, even if the cross-contamination problem is resolved, the scientific community seems to agree that some celiac patients may be able to tolerate oats without any health consequences, while a subgroup of celiac patients simply cannot tolerate any oats. For now, the Celiac Sprue Association says it best with this formal recommendation: aOat products, grown, processed and packaged to be free of contamination with wheat, barley or rye appear to be suitable for some people with celiac disease, but not ALL peoplea Oats is not a risk-free choice for those on a gluten-free diet. Since oats are not a risk-free choice for all people with celiac disease, products containing oats do not qualify to use the CSA Recognition Seal.a FS asks : Is it possible for compromised tight junctions caused by celiac/gluten sensitivity to turn into ulcerations, and over time, into stenoses in the small bowl? Or do MRI-identified stenoses in the small bowl, coupled with chronic anemia, indicate a definitive Crohnas diagnosis? Celiac disease and Crohnas disease can occur together, although very rare to have both. In either disease, diagnostic confirmation has to come from endoscopy-obtained intestinal and colonic specimens (reviewed by an experienced GI pathologist). MRIs, imaging tests and laboratory results cannot confirm Crohnas disease or celiac disease. So, it is important to obtain the full screening work-up and ensure that a board-certified gastroenterologist is overseeing the various points of care. I will comment briefly on the tight junctions, which are microscopic abridgesa joining one cell to another to form an impermeable barrier. Compromised tight junction in Crohnas disease have been documented and studied.

content http://scopeblog.stanford.edu/2013/07/31/stanford-pediatric-gastroenterologist-responds-to-your-questions-on-celiac-disease/

When asked what to look for in a doctor, “I tell people to look for qualities that I hope others see in me,” says Dr Alister George, MD . The first thing Dr Alister George, MD will tell you is to seek a gastroenterologist who is board certified by the American Board of Internal Medicine. A gastroenterologist who is board certified demonstrates that he or she has the proper skills and expertise, comprehension, and experience to practice the gastroenterology specialty of medicine. Dr Alister George, MD will recommend you ask family members or trusted friends when looking for a great doctor. A recent survey at the office of Dr Alister George, MD showed 98 percent of his patients were completely satisfied with the care and service they received. This survey also acknowledged that his patients plan to refer their own friends and family to him. Dr Alister George, MD was awarded the Vitals.com Patient’s Choice Award from 2008 through 2011 by a noteworthy online health resource. In 2010, he was awarded the Vitals.com Compassionate Doctor Recognition Award. The relationship between patient and doctor is not only confidential but also vulnerable. Patients are sometimes reluctant to tell doctors things that can be considered important because they don’t want to feel judged. Dr Alister George, MD says it is extremely important to look for a doctor who cares and who will take the time to listen. It is important to have a doctor listen to your concerns and your needs. Dr Alister George, MD adds that patients should be cautious of a doctor who is quick to rush to the next patient. He further warns them to watch out for doctors who do more talking than listening. Dr Alister George, MD appreciates the feedback he receives from his patients and colleagues, expressing gratefulness toward him for being supportive, understanding, and concerned.

source this http://finance.yahoo.com/news/dr-alister-george-md-good-172400527.html

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