Dr Rodney Ford, a gastroenterologist and food allergy specialist, discusses on Daily Bread: Can Any Human Body Handle Gluten? at TEDxTauranga. Below is the full transcript.
Risk. Did you know that everyday you eat your bread, you are taking a risk? Risk is a strange association to give with this grain of wheat. But in wheat, half of the protein is gluten.
Gluten. This is my model of gluten. I stole it from the toy box in my clinic. And gluten is a very interesting molecule. We didn’t know that it was so harmful – until now. When I was a baby, my mum and dad had no idea that gluten might harm me, or them, or anyone in our family.
This was 1950, when I was a baby, at the same time that Professor Wilhelm Dickie was looking after his patients in Holland. And he noticed and he heard from the mothers of his patients that wheat probably was causing these children harm. And he was the first person in the world to establish that gluten was the cause of what he said is celiac disease.
Celiac disease is a condition where the gluten damages your bowel. When I was in med school, celiac disease was one paragraph in a 2,000-page book. Now, whole books are written about it.
This is me at 10. I reckon my mum did a good job nourishing me despite her lack of knowledge about gluten and any other of the fun intricacies of micronutrients. They were very proud of me, a couple of decades later, when I got my MD a doctorate in Food Allergy because I had been very interested in how foods can make you sick.
This is the classical picture of a celiac child. You can see his big tummy, his thin arms and legs. He feels miserable. He’s in pain most days, he’s not growing. He’s got diarrhea, he’s probably got reflux. He’s stunted. No one knew what to do with him until Professor Dickie showed it was gluten that was the problem.
In 1960, there was the development of what’s called the small bowel biopsy where you could put a tube right down into the intestines, snag a piece of tissue, pull it up and have a look and see. That tissue was damaged by the celiac disease, it was called villous atrophy. And celiac disease became a gastrointestinal illness. Of course, if you’ve got gut troubles, and you’re eating the food that’s causing the trouble, then it must be a gut problem. So the gastroenterologists hijacked the disease.
I’d like to introduce you to another child. This is Elizabeth. She’s given me her permission to show her in the bath. She wasn’t expecting to have this photo shown in Tauranga today. But I didn’t meet Elizabeth in the bath, I met her when she was 6. She came to my clinic, not in a ballet tutu. But looking like this, thin, miserable, she was in abdominal pain, she was refluxing, not growing, her mother was desperate. Desperate to find an answer for the child. Because she was nourishing her child just like my mother was nourishing me, but now she wasn’t growing.
I was in a quandary because I was a junior consultant at Christchurch Hospital running my gastroenterology clinic. But Elizabeth had already been seen by two other professors. They had both declared she had celiac disease, had both done the [fishing] test, bringing the tube down the stomach, pulling out a piece of tissue, and it was negative. They declared she did not have celiac disease.
But Elizabeth was lucky. She came to my clinic and I had an interest in food allergy. And the second reason she was lucky is because of this. The hospital I was at put a brand new test in called the anti-gliadin antibody test. This was brand new and I had the opportunity to do this, I had already done this in England, in another clinic. And the beauty about this; gluten, when you eat it, doesn’t get digested. It can get through into your blood and the immune system hates it. It’s the enemy. It makes antibody against it, and the antibody’s job is to click onto gluten and get rid of it.
We measured this antibody in Elizabeth, and their length was very high indeed. So I went to my colleagues and said, “Look, I know what’s wrong with Elizabeth, after all this time she doesn’t have celiac disease. Gluten is making her sick, I’ve got to put her on a gluten-free diet.” Yep, that’s what they said, nothing. They weren’t astonished, they said, “Rodney, only children with celiac disease were on a gluten-free diet.”
But I went back to Elizabeth’s mum, and we had a chat. That month, the next month, the next month, and after 9 months of chatting I had the courage to put her on a gluten-free diet. And she came back to my clinic the month after that and said, “Dr. Ford, it’s a miracle. She’s got better.”
I wrote in the notes, “At last, we are getting somewhere.”
This is Elizabeth at 8. This is Elizabeth at 10. She’s nowhere like the child we saw earlier on. And I thought she must have a gluten illness which isn’t celiac disease. I thought, going back in my clinic, how many other children had this problem? I hadn’t picked up on it, even if I was a food allergist.
So I began to do the tests. On every child that came to my clinic. And I presented these beautiful children who had negative endoscopy tests, had positive antibodies to gluten, to a medical conference. And it was met with skepticism. I thought, there aren’t enough children.
So I did 100 children next. The endoscopy and blood tests. I presented this to a North American meeting called NETSCAN. There was skepticism. I thought well there’s not enough children. I now presented, the next year, 1,000 children that have come through my clinic. 80% would look better on a gluten-free diet, none with celiac disease. This is the answer. “Dr. Ford, the only children who were on a gluten-free diet are celiacs.”