Self-reported wheat sensitivity, improving safety of breast implants, business as usual for adolescents and antidepressants and is medicine ready for artificial intelligence?

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Is non‑celiac gluten sensitivity a real medical condition or a modern hype?

Dr. Norman Swan 0:00

Hello and welcome to this week's health report with me, Norman Swan. Today is gluten sensitivity a mass modern neurosis fed by a food industry delighted to have new products to foist on us, or is there something to it? The link between breast implants and lymphoma, finding out how real the link is, how common, and as a side benefit, find out which implants perform best. Measuring blood sugar without measuring blood sugar, and whether researchers are Taking a leap into the unknown, allowing self-learning computers to control medical devices, and revisiting the safety and place for the use of antidepressants in children and adolescents. Let's start though with gluten sensitivity. Glutens are proteins which help to give flower products their texture.

Dr. Norman Swan 0:43

There's an autoimmune disease of the small bowel called celiac disease, where the small intestine reacts to gluten and affects maybe one in a hundred astrologers. Australians. But there's been a boom in non Seliac gluten sensitivity, as you've no doubt seen at catered events where there's a gluten free table, not to mention the gluten free products now available in the supermarket, often at higher prices. The question asked by a review of the scientific literature in the Medical Journal of Australia is whether this is an emerging disease or misdiagnosis. One of the authors is Professor Nick Talley of the University of Newcastle. Who's an international authority on what are called functional bowel disorders and is a neurogastroenterologist and is in our Newcastle studio.

Dr. Norman Swan 1:23

Welcome back to the health report, Nick. Thanks so much. Great to be here. What is the prevalence of non celiac gluten sensitivity?

Nick Talley 1:30

Well, it depends who you read, but in Australia we just completed a survey and approximately fifteen percent of Australians believe they are sensitive to gluten or wheat. And so it's very, very common if you go by these data. Fifteen percent. What are the symptoms

Dr. Norman Swan 1:48

that people complain of that think they think they've got it?

Nick Talley 1:50

Well, they complain of a host of symptoms, gut symptoms and extra intestinal symptoms. The gut symptoms are pain, fullness, bloating, sometimes bowel habit change as well. And some of the extra intestinal symptoms include a foggy mind or anxiety or even depression.

Dr. Norman Swan 2:09

So those are symptoms that I thought were more t related to your core interests, which is irritable bowel syndrome.

Nick Talley 2:16

Well, they certainly overlap and that's why we've developed a major interest in this emerging syndrome of gluten or wheat intolerance or sensitivity. And we're beginning to believe there's more than an overlap. There's a real link here and real pathology, at least in some people.

Dr. Norman Swan 2:34

So real pathology. So fifteen percent of people can't be wrong or what?

Nick Talley 2:38

Oh no, no, no. Fifteen percent's a large number I know, but based on the data that's out there and our own emerging information, we think that probably of that group, overall, maybe up to three percent of Australians have a a real disease. And I'm not sure what's going on with the rest who are complaining of this syndrome because we can't at the moment find pathology in that in In many of that group.

Dr. Norman Swan 3:04

Before we go further, we should really just deal with celiac disease. How do you know if you've got celiac disease? 'Cause that is underdiagnosed, it's serious, you can get malignancy in the bowel if you miss it.

Nick Talley 3:13

So celiac disease is an important disease. About, as you said, one in a hundred Australians are affected. You can get a blood test, what's called a tissue transglutaminase test. That's a good screening test. But at least in adults, to confirm the diagnosis, we have to go down and take a biopsy of the top part of the small intestine. So we do an upper endoscopy and we take a biopsy, which is a a very safe and reasonable procedure if uh you suspect this diagnosis. And is it the

Dr. Norman Swan 3:43

same group of symptoms or is it different?

Nick Talley 3:44

It's actually not dissimilar in many ways. And if you look at the symptom profiles of celiac disease and non-celiac wheat sensitivity, there's a lot of overlap of the symptoms.