Many alternative medicine practitioners in the United States, such as chiropractors, acupuncturists, and naturopaths, make false or misleading claims about the diagnosis and treatment of diseases. celiac diseaseaccording to a study recently published in the American Journal of Gastroenterology.
“This is concerning, 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 diets (and perhaps unhealthy) and delays in the diagnosis of other illnesses that may occur. may be the cause of the patient’s symptoms. Dr Benjamin Lebwohllead author of the study and director of clinical research at the Columbia University Celiac Disease Center, said Lisa Rapaport, Reuters journalist.
About 1 percent of the U.S. population suffers from celiac disease, an inherited autoimmune disorder that can damage the intestines and block nutrient absorption. Consumption of gluten, a protein found in wheat, barley, rye and some other grains, triggers the immune response. Symptoms include diarrhea, bloating and gas, abdominal pain, constipation, nausea and fatigue.
Celiac disease is diagnostic with a blood test that looks for high levels of certain antibody proteins. The condition is often confirmed by a procedure called endoscopy, which sends a small camera down the throat and into the small intestine to look for signs of damage. In some cases, a small tissue sample (biopsy) may be taken from the lining of the small intestine.
There is no cure for celiac disease. However, most people can manage this condition successfully by following a strict gluten-free diet.
Celiac disease is not the same as “gluten intolerance” or “gluten sensitivity” (sometimes referred to in the medical literature non-celiac gluten sensitivity, or NCGS). Although some symptoms are the same, NCGS does not cause damage to the tissues of the small intestine.
Many people who believe they are insensitive to gluten, however, are not. A 2015 study found, for example, that more than 80 percent of people who reported gluten-related symptoms did not have celiac disease, NCGS, or a wheat allergy.
Study details
For their study, Lebwohl and colleagues examined the websites of 500 alternative medicine practitioners in the 10 most populous metropolitan cities in the United States (Dallas, New York, Washington, D.C., Atlanta, Chicago, Houston, Boston, Los Angeles, Miami and Philadelphia). ). The selected websites made up the top 10 Google results for each of the five alternative medicine disciplines (chiropractor, naturopath, homeopath, acupuncture and integrative medicine) in the metropolitan area of each city. For integrated practices, only those with a doctor (a person with a medical degree) on staff were counted.
Researchers analyzed marketing claims made on these websites for any mention of celiac disease, NCGS or gluten sensitivity, including claims that practitioners were able to diagnose and treat such conditions. They also looked for statements about the effectiveness of alternative treatments for these conditions, such as “Homeopathy works for celiac disease” or “We can treat celiac disease with chiropractic, which has been proven to work.”
Each statement was classified as “true or essentially true” or “unproven or false.” The categorization was carried out by experts who have written review articles on the treatment of celiac disease and other gluten-related conditions for major international medical journals.
The study found that 178 (35.6 percent) of 500 clinics made 238 separate claims regarding celiac disease, NCGS or a gluten-free diet. Of these claims, 138 (59.5%) were false or unproven.
“Health claims made on clinic websites were diverse and ranged from speculation about the cause of the increased incidence of celiac disease and NCGS to (unsubstantiated) claims that over-the-counter digestive enzymes would provide normal digestive function for people with celiac disease and NCGS,” the study authors write.
Most complaints were made by the clinics themselves, although a small proportion (3.4%) were made through patient testimonials.
Most likely an underestimate of the problem
The study has limitations. The study only looked at English-language websites in the United States. Therefore, the websites examined in the study may not be truly representative of all alternative medicine clinics in the country. Additionally, the Google search did not involve the terms “wheat” and “allergy.” The inclusion of these two words could have resulted in more references to celiac disease and NCGS on the websites examined.
Indeed, Lebwohl and colleagues believe that the actual proportion of alternative medicine practitioners who offer services for celiac disease or NCGS is likely higher than what they found in the study, given that many websites aimed at these practitioners offer few details about their services.
The clear message of this study is “caveat emptor”.
“A substantial proportion of claims (40.5%) (made by CAM practitioners) regarding celiac disease and NCGS were found to be accurate, and it is possible that a patient seeking an CAM specialist could be identified as suffering of possible celiac disease, which leads to an appropriate evaluation (blood tests) and referral to an intestinal biopsy,” the researchers write. “However, it is particularly concerning that some clinics are advertising potentially harmful treatments. »
The claim that digestive enzymes would allow a person with celiac disease or NCGS to eat gluten safely was particularly concerning because it could lead to serious health problems if the person actually consumed gluten, Lebwohl points out. and his colleagues.
“The significant percentage of clinic websites making claims, many of which were false or unproven, suggests the need for increased regulation of CAM marketing to prevent medical misinformation that could lead to harmful consequences,” the researchers conclude. “Efforts are warranted to increase awareness of celiac disease and NCGS, with particular emphasis on combating widespread misinformation. »
MFI: You will find a summary of the study on the American Journal of Gastroenterology websitebut the full study is behind a paywall.
