Joseph A. Murray, M.D., Gastroenterologist, Division of Gastroenterology & Hepatology, Mayo Clinic: I come from Galway in the West of Ireland were celiac disease was very common when I was in medical school. We regarded it like wallpaper. It's just there.
Amy S. Oxentenko, M.D., Gastroenterologist, Division of Gastroenterology & Hepatology, Mayo Clinic: Celiac disease is an immune-mediated condition. So it typically happens in patients who have an immune reaction to whenever they ingest gluten, which would include any foods that contain a wheat, barley or rye. There are some people that truly have a wheat allergy. A wheat allergy does not equal celiac disease.
Dr. Murray: The wheat allergy is a very rapid response. It is very much like the other allergies. Celiac disease is more of a slow burn. It can take weeks or months sometimes for symptoms to start happening in somebody when they're eating gluten.
Dr. Oxentenko: Once they come into our clinic and they want to know do I have celiac disease or not? What we start with is laboratory testing, which includes antibodies that we typically see elevated in patients with celiac disease.
Dr. Murray: These antibodies are pretty specific for celiac disease and so long as a person is on a gluten containing diet, the tests are quite good.
Dr. Oxentenko: Once we have made a diagnosis, the most important thing that we can do is to get them on the correct diet.
Dr. Murray: Patients with celiac disease need to be on a gluten-free diet. That's a medical necessity. It's not a choice. I mean, if patients who continue to have symptoms despite being gluten-free are a particular group of patients that we like to see here. We think with our multidisciplinary experienced approach that we can really drill down on what the reason for why they have continued symptoms.
Dr. Oxentenko: Having the depth and breadth of the services that we have and just the volume of cases that we have really allows that, you know, elevation to that expertise level.
Dr. Murray: I am indeed fortune as a gastroenterologist, as a doctor working in celiac disease, that I can work with this team. We can achieve things that I would find it very difficult to achieve elsewhere.