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Oct/Nov 2013 Issue
A Disqualifying Condition
The Army can accommodate hospital inpatients who require a gluten-free diet but little else is promised when it comes to avoiding gluten. According to Army Regulation 40-501 (Standards of Medical Fitness), “intestinal malabsorption syndromes” disqualify one from enlisting. Although celiac disease isn’t directly addressed by 40-501, the condition can lead to malabsorptive symptoms, explains Col. Stephen A. Harrison, MD, director of medical education at San Antonio Military Medical Center and gastroenterology consultant to the Office of the Surgeon General.
“Celiac sprue can be a severe disorder, even life-threatening in some patients,” Harrison says. “Because of the extreme challenges of deploying to austere environments, where it cannot be ensured that soldiers will be able to adhere faithfully to a gluten-free diet, causing symptoms to flare, it should be a bar to accession.”
Soldiers diagnosed with celiac disease while on active duty are referred to a Medical Evaluation Board (MEB), where their condition is documented and any duty limitations, like deployment, are identified. Entering an MEB doesn’t mean automatic discharge, however.
While it may not be in the best interest of celiacs to routinely deploy, the gluten-free diet is no longer bound so exclusively to celiac disease as it was once. Not every person on the gluten-free diet has celiac disease. Aside from Andrasik, there was at least one soldier at the first gluten-free meeting on KAF who didn’t have an official diagnosis.
A newly recognized condition that’s gained traction among celiac experts—non-celiac gluten sensitivity—can cause similar and just-as-debilitating symptoms as celiac disease, although the condition isn’t believed to carry the same long-term health risks as untreated celiac disease. Others use the gluten-free diet to help ease symptoms related to ADHD, migraines, irritable bowel syndrome and even Lyme disease.