Gluten Dr Briffa link

Not sure if this sort of thing has ever happened in the UK before, perhaps the parents and child discussed by Dr Briffa live in Nottingham. The case is highly complex, but here's the summary:

Wheat=diarrhoea

No wheat=no diarrhoea

Now, to assemble this Apollo 13 rocket, first remove all contents from packaging and make sure all pieces are present, locate an appropriately sized launch pad, take the first nut and an appropriately sized spanner (not supplied)...

The question is whether the dietitian and gastroenterologist can hide behind a negative coeliac antibody test (in a wheat avoiding, currently digestively normal coeliac) to justify their execrable behaviour.

I'm not much of a clinician nowadays, I'm pretty well ruined as far as belief structure in the marvels of the latest anti inflammatory drug or chemo protocol goes, but the one thing that I do still try very hard to do is to listen to my patient's owners. In their own way, from articulate to incoherent, these people are trying to tell you what the problem is. Relying on a set of bloods (normal) and an abdominal ultrasound (inconclusive) will miss you the opportunity to sort out an awful lot of problems.

Luckily the child's problems were limited to the superficial and highly responsive problem of diarrhoea in response to gluten. What if the presenting symptom had been gluten ataxia, hypothyroidism or systemic lupus. Scary.

Anyway, skip's arrived, time to shift some rubble!

Peter