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 "We know that complementary and alternative medicine is widespread,
and people seek out acupuncture, homeopathy and naturopathy for a
variety of reasons, and we also know that avoidance of gluten and
the popularity of the gluten-free diet has exploded in recent years,
far out of proportion to the prevalence of celiac disease," said
senior study author Dr. Benjamin Lebwohl, director of clinical
research at the Celiac Disease Center at Columbia University in New
York City.
"We wanted to know if these two phenomena were linked," Lebwohl said
by email.
To find out, researchers looked at marking claims on websites for
500 alternative medicine providers like chiropractors, naturopaths
and acupuncturists in the 10 most populous U.S. cities.
Overall, 178 sites, or 36 percent, made at least one claim regarding
celiac disease, gluten sensitivity or a gluten-free diet. And 60
percent of these marketing claims were either false or unproven, the
study found.
"This is of concern, given the popularity of complementary and
alternative medicine (CAM) and the fact that misinformation on this
topic can lead to misdiagnosis of celiac disease, unnecessarily
restrictive (and possibly unhealthy) diets, and delays in diagnosis
of other conditions that may be underlying the patient's symptoms,"
Lebwohl said.
Roughly 1 percent of people have celiac disease, an autoimmune
disorder that damages the small intestine if gluten is consumed,
researchers note in the American Journal of Gastroenterology. Gluten
is a protein found in wheat, barley and rye.
Celiac disease has become more common in recent years, due in part
to increased awareness and testing, but also because intolerance to
gluten is becoming more common in the population, they add.
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The condition can be detected with a blood test for antibodies that
show an immune response to gluten in the gastrointestinal tract, and
may also be confirmed by a biopsy of the small intestine. When
celiac is diagnosed, patients are advised to go on a gluten-free
diet to ease symptoms such as abdominal pain, bloating, gas,
diarrhea, anemia and weight loss.
In the study, 40 percent of naturopath clinics advertised at least
one option for diagnosing or treating celiac disease. So did 36
percent of integrative medicine clinics, 20 percent of homeopaths,
14 percent of acupuncturists and 12 percent of chiropractors.
For gluten sensitivity, 45 percent of integrative medicine clinics
advertised at least one diagnosis or treatment, followed by 37
percent of naturopaths, 14 percent of homeopaths and chiropractors
and 10 percent of acupuncturists.
The study wasn't designed to assess health outcomes for anyone who
tried the marketed services.
But there are many potential harms, including the potential for
patients to throw a lot of money away on tests and treatments with
no track record of success, said Dr. Joseph Murray, a researcher
with the Celiac Disease Program at the Mayo Clinic in Rochester,
Minnesota.
There's also the risk that patients will be misdiagnosed, or get
sicker while a proper diagnosis is delayed, Murray, who wasn't
involved in the study, said by email.
"It is well known and often seen that patients who have celiac
disease are more difficult to diagnose properly if they have been
started on a gluten-free diet without sufficient testing first,"
Murray said.
SOURCE: https://bit.ly/2UV2YpY American Journal of Gastroenterology,
online April 24, 2019.
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