Celiac Disease - Gluten Allergy
There is a very common disease of the intestines called "Celiac Disease" whose name comes from the Greek work koiliakos which is translated "abdominal." The disease was first described by Aretaeus of Cappadocia in ancient Greece. However, you don't have to be old or Greek to have this digestive tract disease.
The diagnosis of Celiac Disease is usually delayed (estimated on average to take four years for a person with the disease to have it diagnosed) because the symptoms are associated with many gastrointestinal problems. The symptoms may include: intermittent diarrhea, bloating, abdominal pain, weight loss, fatigue, mouth ulcers and constipation. The stool is often pale colored, greasy and foul smelling. Some of the symptoms are common to many other diseases and as a result difficult to diagnose early.
Celiac Disease is non-discriminatory with regard to gender, race and age. In fact, even the very young can have this disease. The disease is prevalent - approximately one percent of Americans have it with means about three million people in this country. It is diagnosed by knowing the symptoms, then blood tests that are remarkably sensitive and finally by having an endoscopy procedure that includes biopsy of at least five different parts of the upper bowel wall. Endoscopy is upper (through the mouth) as opposed to endoscopy for lower colon cancer (performed at the other end of the gastrointestinal tract). It is important for the diagnosis to be made as early as possible to prevent complications of the disease like anemia, neurological diseases and cancer of the bowel.
The main risk factor of celiac disease is that you have a relative who has it. Having a close relative with it means that your chances are twice as high (1 in 50 compared to 1 in 100). Other risk factors are type 1 diabetes, autoimmune thyroid disease, Down syndrome and microscopic colitis. There is no apparent increased risk with aging (for this column that is the good news).
The cause of this burdensome disease is an immune reaction to gliadin, a protein called gluten, that is found in wheat and a few other grains. The body mounts an immune response to the gluten that causes the small bowel to become deformed and non-functional in its work of absorbing fat and many important vitamins and nutrients. If allowed to persist the bowel looses much of its effectiveness in its important job of keeping us healthy with a balanced diet.
The treatment of celiac disease is simple, but not easy. One must avoid all gluten in the diet - easier said than done. Gluten is naturally in all wheat and related species like barley, rye, triticale and Kamut. These grains find their way into our food supply in many ways, but fortunately in 2007 the FDA issued regulations regarding labeling of foods and now 'gluten-free" labeled products are safe. To treat this disease you must avoid all gluten containing foods. The table below show what to avoid and what is safe. Suffice it to say, any wheat product including bread, pasta, pastries, must be avoided. Oats are safe "if," and this is a big "if," you can be sure they have never been mixed with wheat or wheat processing. Corn, sorghum, rice and wild rice , and buckwheat are all safe. Substitute breads can be made from these gluten-free ingredients. If you remain on a gluten-free diet, the intestine will heal and function normally after time. Symptoms will go away as long as the strict diet is followed. The disease cannot be cured with medicine or surgery.
Foods Safe and Unsafe to Eat with Celiac Disease
Celiac Disease is likely to afflict you or someone you know because one out of every 100 people has it. The disease can be safely managed by observing a strict no-gluten diet. (This is one time that cheating on the diet is really a bad idea.) People with the disease can age normally if they stay on the diet that they should design with their physician and a very good dietitian. When in doubt about what to eat, read the label of the food you are considering eating and tell restaurants when ordering food you must have gluten-free prepared items. All this will keep you safe if you have this dreaded disease.
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For more information consult MUSC Med-U-Nurse or your physician.