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Celiac disease (CD) is also referred to as gluten sensitive enteropathy
(GSE), gluten intolerance, or celiac sprue. It is considered to
be the most under-diagnosed common disease today, potentially affecting
1 in every 133 people in the USA. It is a chronic, inherited disease,
and if untreated can ultimately lead to malnutrition. Gluten intolerance
is the result of an immune-mediated response to the ingestion of
gluten (from wheat, rye, and barley) that damages the small intestine.
Nutrients are then quickly passed through the small intestine, rather
than being absorbed. To develop celiac disease (CD) three (3) things
must be present: 1) you must inherit the gene, 2) consume gluten,
and 3) have the gene triggered. Common triggers may include stress,
trauma (surgeries, pregnancy, etc.), and viral infections. Approximately
1 in 20 first-degree relatives could have CD triggered in their
lifetime. The disease is permanent and damage to the small intestine
will occur every time you consume gluten, regardless if symptoms
are present.
To learn more about the recently published multi-center prevalence
study of celiac disease visit, www.celiaccenter.org.
Symptoms
Celiac disease was once thought of a disease with only GI symptoms.
It is now recognized that the disease is a multi-symptom, multi-system
(organ) disease. Celiac disease also does not routinely present
with the 'textbook' symptoms that physicians learn. More often it
presents with symptoms that can mimic other problems.
Most physicians recognize the classic symptoms of celiac disease
: diarrhea, bloating, weight loss, anemia, chronic fatigue, weakness,
bone pain, and muscle cramps. Physicians may not be aware that celiac
disease frequently presents with other symptoms, some that do not
involve the small intestine. More often, symptoms can include constipation,
constipation alternating with diarrhea, or premature osteoporosis.
Overweight persons may also have undiagnosed celiac disease. Children
may exhibit behavioral, learning or concentration problems, irritability,
diarrhea, bloated abdomen, growth failure, dental enamel defects,
or projectile vomiting. Others will have symptoms such as rheumatoid
conditions, chronic anemia, chronic fatigue, weakness, migraine
headaches, nerve problems such as tingling of hands or difficulty
walking, or other conditions that are unexplained and/or do not
respond to usual treatment. People may have one or more of the above
symptoms. Patients are frequently misdiagnosed as having 'irritable
bowel syndrome', 'spastic colon/bowel', or Crohn's disease'.
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Diagnosis
Initial screening for CD is a blood test taken by your physician.
The test can be referred to as a Celiac Panel or by the names of
the individual tests. To provide the most accurate information,the
blood test should include the following tests: anti-endomysial antibody
(lgA EMA) and anti-gliadin antibody (lgA & IgG), and tissue
transglutaminase (tTG IgA). These tests are very sensitive and specific
for celiac disease. A gastroenterologist takes small intestine tissue
biopsies if the results of the antibody test(s) are positive or
he/she has a strong suspicion of CD. A biopsy showing damaged villi
in the small intestine is the first half of the 'Gold Standard'
to diagnosing CD. The second half of the 'Gold Standard' is improvement
of health with the gluten-free diet.
It is possible, in some situations, to have normal blood tests
and still have celiac disease.
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Treatment
Strict adherence to a gluten-free diet for life is the only
treatment currently available. This involves the elimination of
wheat, rye, barley, and derivatives of these grains from your diet.
Medication is not normally required, unless there is an accompanying
condition, e.g. osteoporosis, dermatitis herpetiformis, etc. Thriving,
showing improvement and return of health on the gluten-free diet
is the second half of the 'gold standard' of being diagnosed with
CD.
Questions to Ask Your Doctor:
- Should I take nutritional supplements?
- Could I have associated food intolerances?
- Where can I have a bone density study?
- What other concerns should I have?
- How can I find out about the diet?
Prognosis
Excellent, if you stay on the gluten-free diet. The small intestine
will steadily heal and start absorbing the needed nutrients. You
should start feeling better almost immediately; however, complete
recovery may take several months to years.
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Related Disorders
Dermatitis herpetiformis is also present in some people with
celiac disease. Other autoimmune disorders that people with CD are
at greater risk to develop include Addison' s disease, autoimmune
chronic active hepatitis, Alopecia Areata, Graves' disease, insulin-dependent
diabetes mellitus (type 1), myasthenia gravis, scleroderma, Sjogren's
syndrome, lupus, and thyroid disease. Thyroid diseases and diabetes
are the two most commonly associated diseases found with celiac
disease. Thyroid disease is most commonly associated with DH.
Other conditions frequently seen in persons with gluten intolerance
include anemia, early bone disease, Downs Syndrome, and fertility
problems. Some persons with DH also have a higher incidence of other
skin conditions, such as eczema.
While other connections have been suggested - such as with autism,
MS, and mycosis fungoides, the research is either inconclusive,
suggests a weak connection or offers no substantial connection.
As knowledge of gluten intolerance diseases expands and new findings
become available, you can expect that the list of associated health
problems and conditions will also change.
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Education
Download the following publications from our site for free. All
documents are in PDF file format. You may click
here to download free Acrobat Reader software.
Celiac Disease
Diabetes
and Celiac Disease
Celiac,
Diabetes, and Me!
Associated
Autoimmune Diseases
Quick
Start Diet Guide
Adding
Fiber to Your Gluten-Free Diet
Also see our Marketplace section for links to books and cookbooks
available on Amazon.com
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