Your Health: Celiac Disease

Celiac disease is a genetic disorder, its symptoms usually triggered after some form of stress, such as surgery, viral infections, emotional stress, pregnancy or childbirth. It is also known as gluten allergy, gluten intolerance, celiac sprue, nontropical sprue, gluten sensitive enteropathy, and affects 1 in every 133 Americans. Normally believed to affect people of European descent (particularly the Northern Europeans), it has only been recent studies which have uncovered that it may also affect people of Hispanic, African, and Asian descent as well.

Considered to be a digestive disease by some, others frequently argue that it also falls under the category of an autoimmune disorder, due to the fact that it is the immune system, itself, that does the damage. Due to the fact that this disease also inhibits the body's ability to absorb nutrients, it additionally falls under the category of a disease of mal-absorption. This has long been a controversial topic, regarding the condition.

Those people who are suffering from Celiac disease cannot tolerate the protein known as gluten. Mainly found in products that contain wheat, rye or barley, it has also been found in materials such as glue adhesives, like the ones used on the back of the stamps or envelopes that we lick. Not only is gluten found in wheat, but also in medicines and is often used in many vitamins. Additionally, oats are suspected to also be toxic to the gluten intolerant, though studies are still attempting to confirm it.

Gluten intolerance causes the immune system to turn on the very body that it's supposed to protect, attacking the tiny finger-like projections, called villa, that line the walls of the small intestine. The purpose of the villa is to soak up important nutrients, which the body needs, in order to function. When these villa are under attack, they often get shortened or flattened down, until they cannot absorb nutrients any longer, thus causing severe complications, if it's left unattended. Without healthy villa present in the small intestine, these people become malnourished regardless of how much or what kind of food that they eat.

Celiac disease affects different people in many different ways. While the most common symptoms include diarrhea, gas, malnutrition, and weight loss, other symptoms can also include irritability, depression, abdominal pain, bloat, fatigue, pale and foul-smelly or fatty stools, bone or joint pains, osteoporosis, osteopenia, seizures, infertility and/or miscarriages, aphthous ulcers inside the mouth, an itchy skin rash known as dermatitis herpetiformis, tooth discoloration and/or loss of enamel, or tingly numbness in the legs, caused by nerve damage. Still other people may have the disease and yet experience none of the symptoms.

Because of the many different ways that Celiac disease affects different people, it is commonly overlooked or misdiagnosed as other conditions, such as Crohn's disease, irritable bowel syndrome, diverticulitis, or chronic fatigue syndrome. Gluten intolerance can cause alopecia areata, a form of hair loss, and lactose intolerance is common in patients that suffer from Celiac disease. Additionally, other conditions can arise, such as lymphoma and adencarcinoma (cancers of the intestine), poor growth rate in children, brittle bone conditions and people suffering from Celiac disease tend to be susceptible to other autoimmune disorders, such as thyroid disease, systemic lupus erythematosus, liver disease, diabetes (type 1), Sjogren's syndrome, rheumatoid arthritis, and collagen vascular disease.

The longer a person goes without diagnosis, the greater their risk is of suffering from malnutrition. This can tie in with symptoms such as anemia, rapid weight loss and poor growth rates in children. Celiac disease is particularly dangerous to children because of this; children need these important nutrients in order for their bodies to grow and develop properly.

There are no precautions to take, to avoid contracting this disease. It is hereditary, meaning that it is passed down through family, and it has been found that about 10% of first-degree relatives (the parents, children or siblings) to those who have gluten intolerance will have gluten intolerance themselves. 30% of fraternal twins and 70% of identical twins, where one twin has Celiac disease, will show that the other tests positive for it as well. For this reason, it is strongly recommended that one should get tested, should they have reason to believe Celiac disease runs in their family, particularly if it is a close relative that was diagnosed with it.

Some studies have shown that the length of time that a child breastfeeds may have an effect on when and how Celiac disease may occur, as can the age at which they started eating foods that contained gluten, as well as how much gluten-based foods they currently eat. Studies suggest that the longer a person was breastfed, the later they will start to develop the disease and the less common their symptoms will be.

Diagnosing Celiac disease can be a tricky thing, especially considering how many other conditions gluten intolerance can mimic. Researchers may have uncovered proof that people with Celiac disease may have a higher number of select antibodies present in their blood. While the results are still inconclusive, a doctor's most reliable forms of testing for Celiac disease are through blood-work and biopsy. Testing blood samples for Immunoglobulin, IgA anti-neodymium antibodies, and anti-tissue transglutaminase can help to tell the doctor whether or not food testing is necessary. It is important, however, that a person ingest gluten, prior to testing. Failing to do so can result in a negative test result.

If the symptoms that the patient is experiencing, coupled with the blood-work results, point to Celiac disease, the doctor will then want to take a biopsy of the bowel. This is done by gently running a tube (known as an endoscope) down the throat, through the stomach and into the small intestine. An instrument can then be maneuvered down the tube and a small sample from the inside of the bowel can be taken, allowing an examination of the villa to be performed.

Currently, the only treatment for Celiac disease is for the patient to maintain a 100% gluten-free diet. Even the most miniscule amounts of gluten in the diet will damage the small intestine, making this special diet a necessity. In order to maintain their health, a person with Celiac disease will have to read ingredient lists and check menus on everything that they intend to eat, for the rest of their life. Depending on what age the patient was when they were diagnosed with Celiac disease, following a strict diet will usually stop many symptoms, heal intestinal damage, and prevent further damage from occurring with the villa.

Maintaining a gluten-free diet can sometimes be very tricky; not only must the patient avoid wheat, rye and barley, but must also be on the constant lookout for spelt, kamut, and triticale. This means that the patient suffering from Celiac disease should also try to avoid most grains, pastas, cereals and many processed or store-prepared foods. On a good note, people suffering from gluten intolerance can use potato, soy, rice, quinoa, amaranth, bean or buckwheat flour instead of wheat, and stores are becoming more conscious of those who are challenged in this fashion; where gluten-free products were originally only found in organic or special health stores, chain groceries are now beginning to sell products that advertise themselves as being gluten free.

This "gluten-free" label is essential; many rice and corn-based products are produced in factories that also manufacture wheat products as well. This can lead in a fine gluten residue being introduced into the other products without knowledge. This can lead to contamination and even a small amount of gluten can do damage to the villa. Additionally, the person suffering from gluten intolerance must also learn about hidden sources of gluten. Many additives, preservatives, and stabilizers can be gluten-based, as well as wheat products often being used as a stabilizer, thickener, and as texture enhancement.

Unaltered foods such as fish or meats, rice, fruits and vegetables are safe as they do not contain gluten. In regards to the controversy as to whether or not those who are gluten intolerant being able to eat oats, the jury is still out and it is highly suggested that the patient speak with their doctor prior to eating anything that is oat-based. Studies are still being done, testing to see whether or not these cause damage to the small intestine.

Eating out can prove very challenging to a person who suffers from gluten intolerance; victims of this disease must be very careful with not only what they buy at the grocery store, but also what they eat in restaurants, at parties, or what they choose to snack on, while over at their friends' homes. Food isn't the only risk however. Some vitamins and medicines can also contain gluten, so it is essential that one check with their pharmacist and inquire as to whether or not their prescriptions are gluten-free. Anyone thinking that they can slip by once in a while would do good to realize that gluten is a poison to a person suffering from Celiac disease.

Some people suffer from a condition known as unresponsive celiac disease. This is usually a case of minute traces of gluten still being present in the person's diet, though this is not always the case. People suffering from UCD appear to show no improvement in their condition, even on a gluten-free diet. In rare cases, the damage to the small intestine's villa is so extensive that the villa can never heal themselves. When their intestines fail to absorb nutrients at all, it may be necessary to direct the nutrients straight into the bloodstream. This is done via intravenous methods, using an I.V. Many physicians believe that refractory or unresponsive celiac disease is a malignant condition; that it is a form of cancer, though this is simply a theory at this point.

Celiac disease is a very serious condition and one that people should be aware of, particularly if it is known that a member of your family has been diagnosed with gluten intolerance. While it can lead to a variety of health concerns, maintaining a gluten-free diet can help to not only lessen symptoms but in many cases, can undo damage that is done. While it seems complicated at first, maintaining a gluten-free diet soon becomes a healthier second nature.