Episode 114: February 20, 2013
by Sanaz Majd, MD
You’ve probably heard all the hype over gluten sensitivity recently. You may have a friend who has advised you to try mitigating your abdominal discomfort and diarrhea by cutting out gluten, or perhaps you saw Nutrition Diva’s episode on gluten-free diets. What is the scoop on gluten sensitivity, anyway?
Well, people who have true gluten sensitivity actually suffer from something called Celiac disease, sometimes referred to as “Celiac sprue.” Let’s learn about it today.
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What is Celiac Disease?
About 1% of the general population currently suffers from Celiac disease. However, this number is likely underestimated due to patients who currently remain undiagnosed. Other common gastrointestinal problems, such as Irritable Bowel Syndrome (IBS), can mimic Celiac and these patients may not realize they have it unless their doctor screens them for it specifically.
Celiac disease has a genetic component, and can be passed down from your parents. It can present at any age, and is sometimes diagnosed later on in life as an adult. People with Celiac have sensitivity to gluten in their diet. Gluten is a protein found in barley, rye, and wheat products, and when it is ingested, it triggers an immune system response in people who cannot tolerate the protein. The immune system causes inflammation in the small intestines which can lead to a number of health concerns.
What Are the Symptoms of Celiac Disease?
When your small intestines become inflamed and angry as a result of being exposed to gluten, patients with Celiac experience the following common symptoms:
Complications of Celiac Disease
Besides the rather unpleasant chronic gastrointestinal discomfort, Celiac disease can cause some other complications as well:
Vitamin D, B12, and folate deficiency
Anemia due to iron deficiency
Low bone density
Increased risk of infertility
Slightly increased risk of cancer – including lymphoma and some gastrointestinal cancers
Increased risk of other autoimmune disorders such as Type I diabetes, rheumatoid arthritis, and Sjogren’s
Diagnosis of Celiac Disease
Celiac disease is easily confused with other more common medical conditions, like lactose intolerance and IBS. Therefore, if you suffer from some of those chronic symptoms previously mentioned, it’s important to rule it out. A simple blood test can diagnose it, however, it is very important to let your doctor know if you have been abstaining from gluten in your diet before your blood test since it can mask the results.
If your blood test shows that you may suffer from Celiac, your doctor may want to confirm it by performing a biopsy of the small intestine.
Treatment of Celiac Disease
There is no cure for Celiac disease. The mainstay of treatment is really to avoid ingestion of gluten in the diet, for life. Abstaining from gluten can eliminate symptoms in several months. But this is much easier said than done. Gluten is hidden in many foods, and it is sometimes very difficult to escape. Patients often report diminished quality of life as a result, and it may be necessary to shop at local health food stores to find a variety of gluten-free products. Always look for the gluten-free symbol on food packaging. Also, beware of gluten in some medications, food additives, and beer. It may be worthwhile to ask your doctor for a referral to a dietician to help you with this challenging task of learning to eat gluten-free. Thankfully, because of increased awareness of Celiac disease over the past few years, many gluten-free products have appeared in grocery store shelves that make it much easier for people with Celiac to eat well. Nutrition Diva has a few grain-alternatives.
Treating Celiac disease can improve risks for lymphoma and osteoporosis, and therefore is something that should not be ignored. It is also important to treat any nutritional deficiencies, including iron, vitamin B12, vitamin D, and folate.
In spite of what you have heard from the world of celebrities, adhering to a gluten-free diet without a true diagnosis of Celiac disease has not shown to be of any benefit. So if you aren’t Celiac, eliminating gluten won’t help you lose weight or be healthier, no matter what the internet myths say.
Do you have Celiac disease? How do you cope? Share your story with us on the House Call Doctor’s Facebook and Twitter pages!
Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
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