Health Care and Celiac Disease

Celiac disease is a serious genetic autoimmune disorder, according to the Celiac Disease Foundation, where the ingestion of gluten leads to damage in the small intestine.  It is estimated to affect 1 in 100 people worldwide.  Two and one-half million Americans are undiagnosed and are at risk for long-term health complications.

If you have celiac disease, eating gluten triggers an immune response in your small intestine. Over time, this reaction damages your small intestine's lining and prevents absorption of some nutrients (malabsorption). The intestinal damage often causes diarrhea, fatigue, weight loss, bloating and anemia, and can lead to serious complications, according to the Mayo Clinic.

In children, malabsorption can affect growth and development, in addition to the symptoms seen in adults. There's no cure for celiac disease — but for most people, following a strict gluten-free diet can help manage symptoms and promote intestinal healing. Because people with celiac disease must avoid gluten — a protein found in foods containing wheat, barley and rye — it can be challenging to get enough grains. More information about this medical issue is located at this website: http://www.mayoclinic.org/diseases-conditions/celiac-disease/home/ovc-20214625 .

Celiac disease cannot be "caught," but rather the potential for celiac disease is in the body from birth. Its onset is not confined to a particular age range or gender, although more women are diagnosed than men, according to the Celiac Support Association. It is not known exactly what activates the disease, however three things are required for a person to develop celiac disease:

·         A genetic disposition: being born with the necessary genes. The Human Leukocyte Antigen (HLA) genes specifically linked to celiac disease are DR3, DQ2 and DQ8...and others.

·         An external trigger: some environmental, emotional or physical event in one’s life. While triggering factors are not fully understood, possibilities include, but are not limited to adding solids to a baby’s diet, going through puberty, enduring a surgery or pregnancy, experiencing a stressful situation, catching a virus, increasing WBRO products in the diet, or developing a bacterial infection to which the immune system responds inappropriately.

·         A diet: containing gluten and related prolamins.

·         Auto-antigen enzyme, tissue transglutaminase (TG2) also TG4 and TG6.

·         Production of proinflammatory cytokines, especially interferon (IFN-γ).

The damage to the small intestine is very slow to develop and is insidious. For more information, visit this website:  https://www.csaceliacs.org/celiac_disease_defined.jsp .

According to this health website: https://familydoctor.org/condition/celiac-disease/ , celiac disease can cause a wide range of symptoms, symptoms that change, or sometimes no symptoms at all. Symptoms of celiac disease may include:

·         Infants and young children who have celiac disease are more likely to have digestive symptoms, such as abdominal pain, vomiting, diarrhea (even bloody diarrhea) and constipation, and may fail to grow and gain weight. A child may also be irritable, fretful, emotionally withdrawn, or excessively dependent. If the child becomes malnourished, he or she may have a large tummy, thin thigh muscles, and flat buttocks. Many children who have celiac disease are overweight or obese.

·         Teenagers may have digestive symptoms such as diarrhea and constipation. They may hit puberty late and be short. Celiac disease might cause some hair loss (a condition called alopecia areata) or dental problems.

·         Adults are less likely to have digestive symptoms. Instead, they might have a general feeling of poor health, including fatigue, bone or joint pain, irritability, anxiety and depression, and missed menstrual periods in women. Some adults may have digestive symptoms such as diarrhea or constipation.

·         Osteoporosis (loss of calcium from the bones) and anemia are common in adults who have celiac disease. A symptom of osteoporosis may be nighttime bone pain.

·         Lactose intolerance (a problem digesting milk products) is common in patients of all ages who have celiac disease.

·         Dermatitis herpetiformis (an itchy, blistery skin problem) and canker sores in the mouth are also common problems in people who have celiac disease.

Celiac disease can develop at any age after people start eating foods or medicines that contain gluten. Left untreated, celiac disease can lead to additional serious health problems, as reported by the Celiac Disease Foundation, such as these healthcare issues:

·         Iron deficiency anemia

·         Early onset osteoporosis or osteopenia

·         Infertility and miscarriage

·         Lactose intolerance

·         Vitamin and mineral deficiencies

·         Central and peripheral nervous system disorders, including ataxia, epileptic seizures, dementia, migraine, neuropathy, myopathy and multifocal leucoencephalopathy

·         Pancreatic insufficiency

·         Gall bladder malfunction

Celiac disease is associated with a number of autoimmune disorders and other conditions, with the most common being thyroid disease and Type 1 Diabetes. More details are available at this site: https://celiac.org/celiac-disease/understanding-celiac-disease-2/what-is-celiac-disease/ .

According to this advocacy website, https://www.beyondceliac.org/celiac-disease/ , there are more than 300 symptoms of celiac disease, and symptoms can be different from person to person. If you have symptoms of celiac disease, especially ones that last a long time, you should ask your doctor for a celiac disease blood test. Left untreated, people with celiac disease are at-risk for serious health consequences, like other autoimmune diseases, osteoporosis, thyroid disease, and even certain cancers.

According to the National Institutes for Health, foods such as meat, fish, fruits, vegetables, rice, and potatoes without additives or seasonings do not contain gluten and are part of a well-balanced diet. You can eat gluten-free types of bread, pasta, and other foods that are now easier to find in stores, restaurants, and at special food companies. You also can eat potato, rice, soy, amaranth, quinoa, buckwheat, or bean flour instead of wheat flour.

In the past, doctors and dietitians advised against eating oats if you have celiac disease. Evidence suggests that most people with the disease can safely eat moderate amounts of oats, as long as they did not come in contact with wheat gluten during processing. You should talk with your health care team about whether to include oats in your diet.

When shopping and eating out, remember to:

·         Read food labels —especially on canned, frozen, and processed foods—for ingredients that contain gluten.

·         Identify foods labelled “gluten-free;” by law, these foods must contain less than 20 parts per million, well below the threshold to cause problems in the great majority of patients with celiac disease.

·         Ask restaurant servers and chefs about how they prepare the food and what is in it

·         Find out whether a gluten-free menu is available.

·         Ask a dinner or party host about gluten-free options before attending a social gathering.

Foods labeled gluten-free tend to cost more than the same foods that have gluten. You may find that naturally gluten-free foods are less expensive. With practice, looking for gluten can become second nature. If you have just been diagnosed with celiac disease, you and your family members may find support groups helpful as you adjust to a new approach to eating. A significant amount of additional support material is found at this website:  https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024528/ .

According to Today, could a normally harmless virus cause a sensitivity to gluten? A new study has found that a certain type of virus could trigger a person’s immune system to overreact to gluten, leading to celiac disease. The findings, published this month in Science, provide an explanation for why certain people develop celiac disease.

People with celiac disease had more antibodies to reoviruses in their blood compared to healthy individuals. Furthermore, these people with more antibodies were found to have more of the celiac disease inflammation. Whether a person was infected with reoviruses at some point in the past could explain why they develop celiac at a certain age or had worse symptoms compared to others who were not infected. More information about this research is found here: http://www.today.com/health/celiac-disease-may-be-caused-virus-new-study-finds-t110119 .

Regardless of your sensitivity to gluten, you should take preventive measures to ensure you have all the answers about celiac disease. You may suffer from it and not even know you have it. See your family doctor or a health care specialist if you have questions or may be experiencing some of the symptoms. Celiac disease has definite consequences to your health. Don’t take chances.

Until next time.