Celiac Disease

[averyrm]

Well, a topic that actually has to do with aeromedical stuff...

Does the FAA have anything against a person with Celiac Disease? I wouldn't think so, but figured I'd ask.

(For people that don't know, this is where your body gets so screwed up it thinks a piece of bread(gluten) is poison and starts attacking your body because you ate it)

[My Flight Surgeon]

I don’t think the FAA has anything against a person with Celiac Disease. Celiac disease can be a serious condition with significant consequences. Because of this I believe an AME should defer issuance of a medical certificate to the FAA and think they would want a full evaluation by a gastroenterologist.

The problem with celiac disease is not just the intolerance to gluten, it is the associated diseases. The mortality ratio for persons with celiac disease compared to the general population is 2.0. That means they are twice as likely to die over a given period of time than a person without celiac disease. The commonest cause of death is non-Hodgkin’s lymphoma. There is also a higher incidence of diabetes, thyroid disease and neurologic diseases in these folks. Other autoimmune diseases have also been identified in persons with celiac disease.

[MidlifeFlyer]

Wow! You mean you'd defer pilot's medical certifciate for not being able to eat pizza????!!!

[My Flight Surgeon]

You missed the point. If there is a history with little or no symptoms, you would get issued. The problem is those with poorly controlled symptoms, the cancer or and other things that can occur with this disease. Would you rather ignore it and die of cancer or face it, be treated and have a Special Issuance so you can fly?

AME's are not out to ground you. We are here to insure you are healthy and can safely (from a health standpoint) operate an aircraft. Just think if it this way, if we tried to "ground" everyone we could, we would be out of business.

[averyrm]

Ok, so what would you want in a letter from a GI? I just found out I have this, and I'm going to get a new medical. No associated problems, otherwise in perfect health. I'm on a gluten-free diet now (no beer;().

I'd rather not have to wait on the FAA to approve it as I'm flying professionally. Is there a chance to not get it defered off the bat? Thanks for your help.

[My Flight Surgeon]

There are two issues here. First. was the diagnosis correct and what was the evaluation? The other one is the letter. What the FAA wants to see is a letter form the treating physician (could be a GI, internist or family doc) that discusses the history of the problem, includes past medical history and family history, a physical examination, discussion of any treatment and how the treatment is working. If there are medications used, what they are, their dose and any side effects you may have. If any tests were done, copies of the reports of all of the tests. If you are basically symptom free on diet, the AME can call the FAA in OKC or the Regional FLight Surgeon and discuss the reports he/she has in front of them. I frequently do this and get a phone authorization to issue the medical certificate. We are still required to submit the documents to the FAA for their records. You would then get a letter stating any followup evaluation the FAA wants you to have. Of note, I have seen figures as high as 80% where applicants for Special Issuance are delayed because they do not supply everything the FAA wants.

Also see your PM from me