Celiac Disease Facts April 16, 2008

Here is a good article about the facts of celiac disease.  Click on this link to see the article Celiac Disease from the American College of Gastroenterology or read it below:

CELIAC DISEASE

By Conor G. Loftus M.D. and Joseph A. Murray M.D.

Division of Gastroenterology and Hepatology

Mayo Clinic, Rochester, Minnesota, USA.

1. What is Celiac Disease (CD)?

Celiac disease (CD) is a chronic (long-term) digestive disease in which patients have
inflammation or irritation in the small intestine, which causes difficulties with absorbing
nutrients from the diet. Patients with CD often have other family members with the
condition and are therefore susceptible to this disease. Inflammation in the bowel occurs
when a patient with CD begins to eat food that contains gluten. Gluten is the name given
to certain types of proteins found in wheat, barley, rye and related grains. Oats are
currently considered not to be toxic to persons with CD. However, due to the high
possibility of contamination with other gluten containing grains, oats are typically not
recommended for people with celiac disease. When food containing the gluten protein
arrives in the small bowel, the immune system reacts against the gluten, causing an
inflammatory reaction in the wall of the bowel. The small intestine lining is covered by
millions of villi (see diagram), which act to increase the surface area of the intestine
allowing improved absorption of food. The villi or finger like projections of the small
intestine are temporarily damaged by the inflammation in CD, which decreases
absorption of food. When gluten is removed from the diet inflammation is reduced and
the intestine begins to heal. The time when a patient develops symptoms varies from
patient to patient after their first contact with the gluten protein.

2. How common is Celiac Disease?

Approximately 1 out of every 250 people may have CD though only 1 out of 10 people
with celiac disease may be actually diagnosed and are aware that they have this disease.
Some of these patients have mild forms of the disease and may have no symptoms or
only mild symptoms. There may be as many as 1 million people in the United States and
3-5 million in the world with CD.

3. Who does Celiac Disease affect?

CD affects whites more often than non-whites. Infants and children may have celiac
disease, but CD is more commonly diagnosed in adulthood, and people can be diagnosed
even in their seventies or eighties. Females are more likely to have celiac disease than
males.

4. What are the main symptoms of Celiac Disease?

The symptoms or signs of disease will depend on how much and how badly the intestine
is inflamed. Some people have mild inflammation with few symptoms. Even though they
may feel quite well there is still damage occurring to the lining of the bowel. Other
people have more severe inflammation, which causes symptoms that may be severe
enough to lead them to visit their doctor. Occasionally individuals will not have any
symptoms even though their small intestine is severely inflamed.

The most common symptoms are:

1. Abdominal pains
2. Bloating and gas
3. Diarrhea
4. Stools that may float or smell very bad
5. Weight loss
6. Poor growth or weight loss in children
7. Anemia (low blood count)
Other symptoms are:

1. Feeling weak
2. Tiredness
3. Low vitamin levels – especially iron, calcium and folate
4. Bone and joint pains
5. Osteoporosis
6. A skin rash that lasts
Someone with celiac disease may have a variety of the above symptoms and different
people with celiac disease may have completely different symptoms.

5. How is Celiac Disease diagnosed?

It is important to remember that most patients with abdominal pain, bloating or diarrhea
do not have celiac disease. In order to test for celiac disease with blood tests and/or
endoscopy the doctor should suspect celiac disease as the cause for the symptoms. When
the doctor thinks that celiac disease is possible, but not very likely, then blood tests alone
are done. If the blood tests are normal, other tests will not be necessary. Sometimes the
doctor strongly suspects that the symptoms are due to celiac disease, or another similar
illness, and will request an endoscopy and biopsy (sampling of the tissue of the small
intestine). All tests for celiac disease must be done while the patient is on a normal diet
that contains gluten. Patients who are concerned that they may have celiac disease should
probably not restrict their diet prior to seeking medical evaluation because this may cause
false test results but they should seek prompt medical testing.

Blood tests:

Specific antibody blood tests are used to diagnose patients with CD. These blood tests are
also used to test people who may be at risk for having CD but have no symptoms
(relatives of patients with CD). The 2 most used tests are the endomysial antibody and
tissue transglutaminase antibody tests. Other tests such as tests for gliadin antibodies are
not as accurate because they can be abnormal in patients who don’t have celiac disease
and are healthy or in people with other digestive problems. Other tests for allergies will
not detect celiac disease. Tests on saliva or stool for antibodies are not good substitutes
for the blood-based tests.

Endoscopy:

Establishing a firm diagnosis of CD requires taking biopsy samples of the small bowel
using endoscopy. Endoscopy involves insertion of a thin flexible tube through the mouth
into the stomach and small bowel. Samples are taken from the wall of the small bowel
and are examined under a microscope for changes of CD. This test is usually performed
with the aid of sedatives.

6. How is Celiac Disease treated?

Celiac disease is treated by avoiding all foods that contain gluten. Gluten is what causes
inflammation in the small bowel. When this is removed from the diet, the bowel will heal
and return to normal. Medications are not normally required to treat CD except in
occasional patients who do not respond to a gluten free diet.

 

Gluten-free diet:

The following grains contain Gluten and
are

NOT ALLOWED IN ANY FORM:

Wheat, rye, barley, kamut, einkorn, spelt
and triticale

Frequently overlooked foods that often contain gluten

Breading

Imitation bacon

Broth

Imitation seafood

Coating mixes

Marinades

Communion wafers

Processed meats

Croutons

Sauces

Pastas

Stuffings

Getting used to the gluten-free diet requires some lifestyle changes. The key to
understanding the gluten-free diet is to become a good ingredient label reader. If a food
has questionable ingredients avoid it and find a similar product that you know is gluten-
free. Foods containing the following ingredients are questionable and should not be
consumed unless it is verified that they do not contain or are not derived from prohibited
grains; these products are:

Unidentified:

Modified food starch
Hydrolyzed vegetable protein (HVP)
Hydrolyzed plant protein (HPP)
Malt vinegar
Soy sauce or soy sauce solids
Brown rice syrup
Dextrin
Textured vegetable protein (TVP)
Vegetable gum
Be aware that medications may contain gluten ingredients. Gluten containing fillers may
be in both prescription and over the counter medications. It is essential to ensure that any
medications being taken are gluten free.

ALLOWED

Rice, corn, soy, potato, tapioca, bean,
sorghum, quinoa, millet, buckwheat, tef
and nut flours

7. For how long do you remain on the gluten-free diet?

Once a diagnosis of CD is established, these individuals need to remain on the gluten-
free diet for the rest of their lives. While this may be difficult at first, patients usually
adapt quite well over time.

8. Is there any other way of treating Celiac Disease?

No. There is no other treatment currently available. All patients with CD must remain on
a strict gluten-free diet. Medications are not normally required. Supplemental vitamins,
calcium and magnesium may sometimes be recommended but patients are advised to
check with their physician about these supplements. Rarely steroids or other drugs are
used to suppress the immune system but only in the most severe of cases.

9. What will happen if you don’t adhere to the gluten-free diet?

Patients with CD who do not adhere to the gluten-free diet usually continue to suffer
from symptoms such as abdominal pain, bloating, gas and diarrhea. In addition, these
patients are at higher risk for developing complications of CD such as cancer of the small
bowel and narrowings in the bowel due to inflammation.

10. What are other complications of Celiac Disease?

Other complications of CD that may be avoided by strictly following a gluten-free diet
include tiredness, poor growth, decreased adult height, osteoporosis, bone pain, joint
pain, difficulty having children, narrowing of the intestine, cancer of the esophagus (food
tube) and small bowel, lymphoma (another type of cancer) and neuropathy (unsteady
walking and confusion which may be severe).
11. Where can I find more information on Celiac Disease?

http://www.celiac.org/
http://clinicaltrials.gov/ct/gui/action/FindCondition?ui=D002446&recruiting=true
http://www.naspgn.org
http://www.med.utah.edu/pated/handouts/handout.cfm?id=874
http://www.celiac.com/cgi-bin/webc.cgi/st_main.html?p_catid=21
http://www.celiac.com/cgi-bin/webc.cgi/st_main.html?p_catid=16
http://www.causeyourespecial.com/aboutus.html
http://www.allrecipes.com/directory/586.asp
http://www.celiac.com