Monday, March 10, 2008

Celiac Disease: Not as rare as most doctors think

Celiac disease is a chronic illness that affects 1 in 133 Americans. It is a condition where the body is allergic to gluten, a protein found in wheat, rye and barley (and also in cross-contaminated oats). The immune system thinks that gluten is an invader like a virus or bacteria and develops antibodies against it, attacking it and consequently damaging the lining of the small intestine, the part of the intestine which absorbs nutrients from the foods we consume. As long as the person afflicted with this condition continues to consume gluten or gluten-containing foods, the attack will never relent, with damage and inflammation only getting worse over time.

There are tiny finger-like projections in the small intestine which are designed to absorb nutrients and fats from the foods we eat. In the person with Celiac Disease, these finger-like projections become progressively damaged due to the immune system's attack as it tries to "get rid of" gluten. Eventually the small intestine becomes so inflamed and damaged that it can no longer absorb vitamins, minerals, fats and other nutrients properly. Instead, these just pass on through and out of the body, resulting in diarrhea, possible weight loss and malnutrition.

Symptoms aren't the same from person to person. Some people are diagnosed when they are young due to poor growth and low weight. It was thought, only until recently, that only children had Celiac Disease and that the incidence was quite low - only 1 in 5000. However, doctors are now beginning to realize that this condition afflicts up to 1 in 133 people in the United States. Symptoms may not become apparent until adulthood and they may be mild, instead of severe.

There is no cure for Celiac Disease, but there is an effective way to test for and treat this condition. There is a simple antibody test that you can ask for from your physician, along with a recommended colonoscopy to check for inflammation and damage caused by the disease.

The treatment is a lifelong, strict adherence to a gluten-free diet. This means not eating most processed foods and being very careful where you eat when you do eat out at restaurants. I have Celiac Disease and eat only whole foods. This way I can be assured that nothing I eat contains gluten. Medications should also be checked for any excipients or fillers which may contain gluten. Most medications don't contain gluten, but be sure to call your pharmacy or the pharmaceutical company which manufactures your medication just to be sure.

Even tiny amounts of gluten can trigger an inflammatory response and if left untreated, folks with Celiac Disease will face a 1 in 10 chance of contracting lymphoma, a type of cancer that affect the lymph nodes. Failing to adhere to the gluten-free diet can also lead to depression and anxiety because tryptophan cannot be absorbed properly. Tryptophan is an amino acid that is converted to the mood-elevating neurotransmitter serotonin in the brain but must be absorbed through the small intestine first.

After beginning a gluten-free diet, you will feel better, with less acid reflux, no more diarrhea and perhaps even less anxiety and depression as the small intestine begins to heal itself. I've been on the gluten-free diet for more than a year and feel a world of difference.

Although awareness is increasing of this condition, a lot of physicians are still in the dark and misdiagnosis is common, with symptoms being blamed on a "spastic colon" (Irritable Bowel Syndrome), GERD (gastroesophageal reflux disease), lactose intolerance or anxiety.

Gluten is a very hard to digest protein and whole foods are much more healthy for you anyway, so I recommend a diet rich in fresh fruits and vegetables rather than a diet that contains pasta, breads or other sources of wheat.

You'll most likely feel better on a gluten-free diet even if you don't have Celiac Disease, so please do give whole foods a try. Your body will thank you.


Jeffrey Dach MD said...

Celiac Disease is commonly associated with Hashimoto's Thyroid Disease, Adrenal disorders, Osteoporosis, Alopecia areata, chronic abdominal pain, Skin disorder called Dermatifromis Herpetica, Vitamin K and B12 deficiency, Iron deficiency Anemia, Peripheral Neuropathy, and other neurological disorders. It tends to run in families and has a genetic component.

To read more: Celiac Disease by Jeffrey Dach MD

Jeffrey Dach MD
my web site

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