Living With Celiac

Gluten is a protein that is found in Wheat, Rye, Oats and Barley. In certain people, this protein is seen as an invader by the body and the body’s own defense mechanism attack it. The area under attack is the villi, the small finger like projections in the small intestine, where absorption takes place. This is called Celiac Disease. The only but highly successful solution to Celiac disease, is to follow a completely gluten free diet.

The history:

About 10000 years ago, mankind moved away from a purely hunter -gatherer society and the began to grow his own grains, thus causing the start what we know today as agriculture. It was the first time crops of wheat and barley appeared. This also coincided with the beginning of what we now know as celiac disease. As we became more advanced farming methods improved. This was especially true during the agricultural revolution at the end of the 18the century and beginning of the 19th century, as farming methods became more and more technologically advanced, grains became a common part of our diet.

As today, it forms the majority of the Western world’s modern diet. Almost every dish or food substance in our fast paced modern convenience lifestyle contains gluten in one form or another.

In celiac disease, there is an abnormal immune reaction, known as an auto immune reaction, where the body sees the proteins found in gluten as a foreign invader. The area of the body that is attacked is the viili or finger like protrusions that make up the small intestine. This is the area of the colon where the absorption of all the food we eat is takes place and nutrients are transported to the blood stream for use in the body. In celiac disease, these villi, atrophy and cannot properly work. Therefore no matter how much food is eaten, the body cannot properly absorb it and this leads to malnutrition.

Other symptoms include:

Digestive complaints

abdominal bloating and pain
chronic diarrhea
vomiting and nausea.
constipation
pale, foul-smelling, or fatty stool ( due to the mal absorbed foods)

And other symptoms include

o weight loss
o unexplained iron-deficiency anemia
o bone or joint pain
o bone loss or osteoporosis
o depression or anxiety
o tingling numbness in the hands and feet ( known as neuropathy)
o arthritis
o seizures
o fatigue
o missed menstrual periods
o infertility or recurrent miscarriage
o dermatitis herpetiformis ( occurs in about 20% of Celiac patients)

Often there are many incorrect diagnoses until the correct one is made. This is made by blood tests, which determine if there are the anti bodies in the body to gluten and then a gastroscopy, in which a small camera can see into the small intestine and a biopsy is made to confirm diagnosis.

Despite the digestive problems and other symptoms, it vital to remain gluten free after diagnosis, as continuing to expose the body to gluten can lead to malignancies of the colon itself.

Luckily maintaining a gluten free diet is possible and relatively easy and will lead to improved health and well being.

Great to see more and more articles been written and published on Celiac Disease. This one is great; looking forward to see what comes next.

Check it here

World wide it seems Celiac Disease is being under diagnosed. Despite its relative ease in diagnosis, involving blood tests and a gastro-scope biopsy, it is very commonly overlooked. Doctors often mistakenly believe that it is a rare disorder, even though current statistics show it at 1% of the population (this is for the US and UK; there seems to be little other data available elsewhere). This number is assumed to be even higher amongst the many undiagnosed patients. It can also be a hereditary disease and can run in families. It also is more common in people who already have other autoimmune diseases, such as Hypothyroidism, Rheumatoid Arthritis, Addison’s Disease and Type 1 Diabetes.

Another reason for it being overlooked is that there are so many overlapping disorders with common symptoms. There are people who have digestive disorder symptoms, commonly diagnosed with Irritable Bowel Syndrome (IBS), pain and fatigue, diagnosed with Fibromyalgia, with pain in their joints, diagnosed with Arthritis, yet they all might have Celiac Disease.

There are also people who have it without any symptoms besides iron deficiency anemia. People seem to commonly be treated for Arthritis or Osteoporosis or Irritable Bowel Syndrome(IBS) or Anemia and treated for these disorders without finding the root cause of the problem.

There is even the controversial idea that because it is a disease without a cure that requires medication, there is no support or funding from the Pharmaceutical industry in supporting its testing. The only treatment for Celiac is to follow a gluten free diet, and when this is done all symptoms clear up. Whereas the Pharmaceutical industry would much rather push for the anti depressants, anti inflammatories, painkillers and other medication that are used to treat the symptoms of Celiac.

Either way whatever the reason, we can no longer plead ignorance on the subject, Doctors, especially those in primary care, need to start sending patients for the tests and we need to educate the general population about it and how it is treated. It is not just some rare disorder, it is more common than people realize. The more our diets begin to rely so heavily on the white flour, highly processed, highly refined, convenience food, the more diagnoses will appear.

Celiac disease is not an allergy to gluten, like a wheat allergy is. It is in fact an autoimmune disease that is the body mistakenly attacks its own tissues seeing them as a foreign substance.

When a person with Celiac Disease eats any food containing gluten, the body reacts to those proteins found in the gluten and attacks the small finger like projections in the small intestine called villi, thus preventing absorption of nutrients.

The tests for Celiac disease involve two blood tests for anti-tissue transglutaminase antibodies (tTGA) and anti-endomysium antibodies (EMA). These are the markers for the antibodies that are produced in response to gluten in a body with celiac. If these tests are positive, then one will have to undergo a gastroscopy, in which a small tube is inserted down the mouth (you are asleep so are not aware of anything happening) and a small biopsy is taken of the lining of the small intestine to investigate whether there is damage to the villi. Even if blood tests are negative, a biopsy may still come back positive.

Then a gluten free diet will have to be maintained for life. It is dangerous to continue eating gluten, not only because of the illnesses one has, but also because left untreated, it can lead to cancer of the colon itself.

So it is vital that our primary care physicians more commonly check for Celiac Disease.

Great minds think alike. The New York Times just posted an article on the under diagnosis of Celiac.

Check it out here

Why does there seem to be such under diagnosis of Celiac Disease?
Why does the medical community continuously overlook it?

I have had chronic anaemia for almost all of my life, yet because I was a woman, it was almost accepted that this is “normal”. My constant stomach problems as a child called “spastic colon”, to an adult being called “irritable bowel syndrome”. Not that this isn’t a real condition or even that I don’t still have some features of it, but it was in my case almost a dismissive diagnosis, “we don’t know what else it is, it must be IBS”. Then most significantly the thing that affected me the most was my fibromyalgia causing constant fatigue and muscle and joint pain. Again this tended to be a basket case diagnosis. The doctors thought there must be an underlying condition, but never knew what it was.

I went from specialist to specialist, none of them quite able to pinpoint what was wrong with me. I was even originally mistakenly diagnosed as having Multiple Sclerosis (MS). Its crazy now that I have a diagnosis to look back and be able to join the dots and see how all my many varied symptoms can all come from the same point.

The discovery of my Celiac disease came by pure fluke. My blood tests continually showed very low iron, despite iron transfusions and very low thyroid, despite replacement thyroid medication. My GP was concerned and decided to send me to a Haematologist who decided we needed to find the source of this and not just keep trying to treat the symptoms (yay finally someone who thought like me!). She did a whole lot of blood tests and it took a few weeks, but the anti bodies for gluten came back positive. I had high levels of antibodies. IGA and IGG and I was also positive for anti-endomysial antibodies.

The next step in the diagnostic procedure was that I had to undergo a gastroscopy and a biopsy was taken of my small intestine. All of these tests then confirmed that I did indeed have Celiac Disease.

Since coming off gluten, its as if by some miracle, all my symptoms of all my other ‘illnesses’ have mysteriously disappeared. I no longer have fibromyalgia, or IBS or joint pain or fatigue and all my blood test results are normal. It is a simple thing to diagnose, yet so overlooked by the medical community. We need educate people about Celiac disease and encourage our doctors to test for it!