May is Celiac Awareness Month
Celiac disease is best known for damaging the lining of the small intestine, preventing the individual from absorbing the parts of food integral to staying healthy. The damage is caused by a type of auto-immune reaction from eating wheat, rye and barley. Oats may also contribute to celiac disease.
The small intestinal villi are damaged by the person’s own immune system after eating food containing gluten. Since we absorb many nutrients through these villi, malnutrition will occur no matter the amount of food consumption.
A family history of celiac disease is indicative of an increased risk for celiac disease. Celiac disease can develop at any age in one’s life. It doesn’t have to start in childhood.
Celiac Disease Causes Increased Risk for Other Diseases
- Down syndrome
- Sjogren syndrome
- Thyroid disease
- Addison’s disease
- Rheumatoid arthritis
- Intestinal cancer
- Lactose intolerance
Symptoms May Include
- GI symptoms and discomfort including diarrhea and constipation
- Appetite changes
Additional Symptoms Due to Malabsorption May Include
- Hair loss
- Mouth Ulcers
Treatment of Celiac
In practice we find it difficult to get patients to stick to a gluten free diet. Exposure to gluten is so common in the US diet that it is difficult to avoid without being knowledgeable about the sources of gluten. Studying the diet is essential before starting a gluten free diet. Gluten is found in a variety of different products besides the obvious ones.
Diagnosis can be through blood tests and biopsy. If you’ve been eating a gluten free diet it is important to note that you will most likely test negative as the tests change when you aren’t exposed to gluten.
Non-Celiac Gluten Sensitive
Gluten Sensitivity is a completely different set of problems than celiac disease. The majority of people with gluten sensitivity will never develop celiac. Gluten sensitivity can affect up to one out of every 20 individuals.
The range of symptoms differs in people with gluten sensitivity. Their immune system responds to gluten both in and out of the gut which creates inflammation throughout the body. While people with gluten sensitivity may have some damage to their gut they may have a variety of other symptoms. The majority of their symptoms may not be related to gut problems but other systemic disorders.
Gluten Sensitivity Symptoms
- Thyroid disorders
- Many more
Diagnosis of gluten sensitivity is not as straightforward as a biopsy diagnosis for celiac disease. Since there are such a variety of symptoms we suggest patients try doing a gluten free diet for one month to see if their symptoms subside. We see a lot of people with chronic problems improve significantly on the gluten free diet. In my experience, it is often when people cheat after maintiaining a gluten free diet that they become convinced of the harm gluten is doing them - they often see their symptoms aggravated and return after even minor exposure to gluten.
Wheat Allergy vs. Celiac/Gluten Sensitivity
A wheat or gluten allergy is not the same exact thing. While the diet would be the same the symptoms are different. What really varies is the extent of the damage done.
It is not unusual for people with mild allergies to occasionally expose themselves to wheat and gluten and suffer the brief negative consequences. However, with celiac and gluten sensitivity, exposure doesn’t just result in a small group of symptoms; it triggers a complex immune reaction that, once set in action, continues to cause damage for days, weeks and months. In fact those with celiac who expose themselves to gluten only once a month have an increase in mortality rate by 600%.
You can’t treat celiac or gluten sensitivity the same way you would treat any allergy. You need to make sure that you practice complete abstinence from gluten as the health costs from exposure are too great.
There is an article that questions the safety of gluten in even healthy people’s diet. The study showed that even people without celiac suffered from immune response to gluten.
A gluten free diet is a big commitment. I find Country Life Vitamins and Metagenics the best gluten free supplements. We like to use Metagenics Ultra InflamX as support for patients with gluten problems. We find this product is very helpful in controlling inflammation.
Make sure to check out our selection of gluten free foods.