Unexplained Anemia? Test for Celiac Disease

According to the American Gastroenterology Association (AGA), celiac disease (CD) should be considered in any patient with unexplained iron deficiency anemia. The AGA describes celiac disease as a permanent intolerance to gluten, the storage protein found in wheat, barley, and rye. CD is characterized by a chronic inflammatory state that disturbs the workings of the small intestine and its ability to absorb the nutrients, including iron, critical to good health.

For over a year, I could not get through a day, or even an hour, without crunching ice. I often wore a coat in the house, stood by a heater, and consumed one cup after another. Sometimes I sat in a steaming bathtub of water and munched away. My husband joked that I had a bag-a-day habit, but the reality was no joke. I experienced frequent headaches, jaw pain, damage to my teeth, and needless medical treatments. What I didn't know then is that doctors have a term for crunching ice: "papohagia." It is frequently associated with iron deficiency anemia.

In addition, I experienced a host of seemingly unrelated symptoms, such as excruciating leg and foot pain, bloating and gas, mouth sores, fatigue, and painful joints. This went on for years. I remember several visits to doctors who arrogantly stated, "There's nothing wrong with you." I wondered if I was a hypochondriac, even though I was in pain most of the time.

Further medical evaluation seemed pointless until one afternoon when I received a phone call from my sister. She said she'd been diagnosed with a little known inherited condition called CD. I'd never heard of it, but couldn't wait to learn more. The first site I pulled up on the internet listed every one of my symptoms.

I obtained a referral to a gastroenterologist and underwent diagnostic testing, including blood tests to screen for antigliadin (AGA) and endomysium antibodies (EmA), and biopsies taken from several places in my small intestine. The blood tests and the intestinal biopsies are the standard for a formal diagnosis. Within a couple of weeks I finally had the answers I had been looking for. I, too, had CD. Not only that, but my blood work confirmed anemia. I began a gluten-free diet and iron supplementation. Within weeks all my symptoms diminished, including the ice craving.

I no longer need iron supplements, but I do have to adhere to a gluten-free diet for the rest of my life. It can be difficult, especially when I eat out or crave a favorite food. I can't complain, though. It is a small price to pay for renewed health. It is wonderful to be ice free, as well. I much prefer a warm cup of tea.

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Technical information for this article can be found at http://www.gastrojournal.org/article/PHS001650850602 2268/fulltext
http://www.mayoclinic.com/health/chewing-ice/AN012 78
http://www.celiacdisease.net