Modern medicine defines celiac (coeliac) disease as gluten intolerance. But just before this idea was accepted, another theory gained prominence - and suggests a cure.

In Breaking the Vicious Cycle: Intestinal Health Through Diet, author Elaine Gottschall presents a new model for healing digestive disorders with an approach called the Specific Carbohydrate Diet. Perhaps the most controversial aspect of the book, however, is Gottschall’s revisioning of celiac (or "coeliac") disease.

History of the Celiac Diagnosis

In an addendum to the book, titled “The Celiac Story,” Gottschall presents the history of the celiac diagnosis and discusses a breakthrough that linked celiac symptoms to certain complex carbohydrates.

By the late 1940’s, Dr. Sidney Valentine Haas was well-known for his treatment of Celiac patients with the Specific Carbohydrate Diet, a dietary plan that eliminates the indigestible (to a celiac) carbohydrates in grains, sugar, and milk. Without constant aggravation from these specific carbs, the intestine can heal itself within as little as a year, relieving all sign and symptoms of celiac and other intestinal disorders.

Despite success with his patients and some acclaim, Dr. Haas’s theory of celiac disease was overruled by a 1952 Lancet report (based on only ten test subjects) suggesting that gluten protein intolerance might be the “real” culprit in celiac disease.

Gottschall suggests that the simplicity of the solution was a factor in the medical community linking celiac disease, up to the present day, with gluten intolerance.

Why “Gluten Intolerance” is Not Good Enough for Gottschall

Gluten intolerance is not really enough to explain celiac disease, since symptoms do not disappear when gluten is eliminated from the diet. In some cases, avoiding gluten restores health and improves digestive symptoms. However, according to Gottschall, it does not result in healing of the intestinal wall.

Even celiac patients who avoid all gluten continue to demonstrate deformed cells in the intestinal wall - a signal that something in the body is still out of balance.

By avoiding starches and the polysaccharides (complex sugars) that aggravate celiac and other intestinal conditions, the intestinal wall is actually able to heal itself. Cells will be healthy and test normal after a period of one to five years on the diet.

Testing for Gluten-Induced Enteropathy Celiac Disease

Gottschall also criticizes the tests used in diagnosing celiac disease. She believes that the results of the intestinal biopsy tests used to diagnose celiac are inconclusive. The flattened or blunted appearance of intestinal cells that is key in diagnosing gluten intolerance also occurs in other conditions, or it may be due to any number of factors in the diet.

Gottschall also comments on the variety of diagnoses given to those with the same symptoms as celiac patients: “idiopathic (from unknown causes) diarrhea, tropical sprue (diarrhea of the tropics), non-tropical sprue, steatorrhea (fat in the stool), failure-to-thrive syndrome, or malabsorption.”

Despite identical symptoms, the difference between these patients and a “true celiac” is the results of a (potentially flawed) biopsy - resulting in entirely different treatments for what may be the same disease.

If Not Gluten, Then What?

According to the research of Dr. Haas and his son, Dr. Merrill P. Haas, the trouble in celiac disease is not gluten, but sugar: certain complex carbohydrates whose structure makes them difficult for the digestive system to break down. These disaccharide and polysaccharide sugars are left unabsorbed in the intestine, leading to bacterial overgrowth and damage to the intestinal wall.

Some experts have suggested that it might even be the undigested sugars that cause gluten intolerance.

Gottschall’s Solution: Dr. Haas’s Specific Carbohydrate Diet

Whether the origin of celiac is poor digestion of carbs, or gluten intolerance in fact, Gottschall has found success with patients using the Specific Carbohydrate Diet developed by Dr. Haas, the same diet she used to cure her eight year old daughter’s “incurable” ulcerative colitis. The diet is entirely gluten-free, as well as avoiding specific sugars.

For more information about the Specific Carbohydrate Diet, see Breaking the Vicious Cycle.