I have a twenty five year history of food allergic disease. For several years I knew that wheat-containing foods injured me, sometimes in serious ways. I eventually developed Dermatitis Herpetiformis and recognized the association of my illness with celiac disease. As a result of my own experiences, I changed my medical practice, learned immunology, nutrition and skills of patient management that are required to guide patients toward major changes in diet and lifestyle.

After 20 years of studying gluten-related diseases, I have a long list of unanswered questions and no easy solution has emerged. The concept of celiac disease is seriously flawed, mostly because only a small subpopulation of people made ill by eating gluten have changes in their intestinal lining, and physicians decided that they would only pay attention to these people. Everyone else was ignored. This is a human kind of irrationality, not limited to physicians.

The true prevalence of gluten-related disease is unknown. My working assumption is that gluten- related disease afflicts at least 20% of the population of Canada, Europe and the United States. The possibility that disease is gluten-related is almost never considered by physicians. Since gluten-related diseases span many medical specialties, the opportunities for discovering the common link to gluten intake are limited. A typical patient sees several specialists over many years and accumulates a list of diagnoses and treatments.

The readers of this book will be intelligent, well motivated people who are empowered to make their own decisions and treat their own illnesses with diet revision. I have emphasized the knowledge we have of celiac disease and provide all the information a celiac person needs to self-manage effectively. At the same time, I want the non-celiac reader to feel welcome and included in the discussions. My guess is that non-celiac gluten sufferers are at least 20 times more common than patients diagnosed with celiac disease.

Stephen Gislason M.D.