Monday, November 12, 2012

When Gluten is not Your Friend

    Going gluten-free is all the rage for celebrities like Oprah Winfrey and Gwyneth Paltrow, but living without many foods like cereal, pizza and salad dressing can be hard—just ask someone with celiac disease. According to the National Digestive Diseases Information Clearinghouse (NIH), 1 in 133 people have celiac disease, a unique autoimmune disorder that damages the small intestine and interferes with absorption of nutrients from food. The body's immune system causes it to overreact in response to gluten in food—like wheat, barley and rye.

The gene factor
     Celiac disease can crop up at any age, but often has a genetic link. Sometimes an environmental trigger, like a viral infection or severe emotional stress, might jump-start the disease process in genetically susceptible people. A celiac diagnosis is not as uncommon as it once was, according to gastroenterologist Nelson Ferreira, MD. 

     “Physicians are looking for the disease, especially in patients with gastrointestinal issues,” says Dr. Ferreira. Other specialists like OB/GYN doctors also have celiac disease high on their radar.

     Symptoms of celiac disease can include diarrhea, fatigue, constipation, abdominal bloating, skin rash, weight loss, joint pain, iron deficient anemia, elevated liver enzymes and brain fog. According to Dr. Ferreira, the best way to diagnose celiac disease is by a blood test and an upper endoscopy, where a physician takes a biopsy of the small intestine.

Living with celiac disease
     The only way to treat celiac disease is to remove gluten from your diet—and that’s hard work. People diagnosed with the condition must carefully read food labels and watch for cross-contamination of cooking and food-prep surfaces. To make matters worse, gluten can be found in makeup, toothpaste and even medicine capsules, so like a food allergy, people with celiac disease must stay ever vigilant.

      Left untreated, celiac disease can lead to iron and vitamin D deficiencies that affect vital organs, the nervous system and your bones. As with any disease, it’s best to identify the disorder in its early stages.

Gluten sensitivity: celiac’s cousin 
     While celiac disease affects a small percent of the U.S. population, more people are being diagnosed with a condition called non-celiac gluten intolerance (NCGI), or gluten sensitivity. “Like lactose intolerance, there’s a valid association between digestive issues and gluten—it’s not just in someone’s head,” explains Dr. Ferreira. After a gastroenterologist rules out celiac disease, those patients with suspected gluten intolerance must eliminate gluten from their diets as a way to determine whether they’re gluten sensitive. Often patients feel better once they’ve adopt a gluten-free diet.

Hope for the future
     Meritus Medical Center is currently conducting a phase III clinical trial for a new medication that allows celiac patients to safely digest gluten and not experience the side affects. The trial is open to patients on a gluten-free diet but still experiencing bloating, abdominal pain and diarrhea. For more information, contact Angela Angstadt, Clinical Research Coordinator at 301-665-4608.

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