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Celiac Disease submitted by Anniteh Zanne, Penticton BC October is designated as Celiac Disease awareness month. Celiac disease covers a spectrum of illness from ambiguous, relatively mild digestive symptoms to more destructive and even life-threatening disease. Celiac disease has no cure or medical treatment. Celiac disease is associated with a variety of autoimmune disorders which is an immune mediated response to gluten, the proteins found in cereal grains which are a common cause of the disease. For persons with celiac disease the toxic part of the gluten molecule is the prolamin portion: apha-gliadin in wheat, secalin in rye, horedin in barley and evedin in oats that causes a reaction to the mucous lining of the intestine. The gluten found in corn and rice does not contain this toxic portion. Celiac disease affects nearly 2.1 million people and many times they do not even know it. Celiac disease (CD) occurs at all ages in both males and females. The prevalence of celiac disease in the general population was believed to be 1 in 300, but recent evidence suggests that there are more undiagnosed than diagnosed cases. A revised estimate of the prevalence in the general population may be as high as 1%. The prevalence of CD among first-degree relatives of people who are diagnosed with CD is as high as 15%. In families with sibling pairs affected by CD, the prevalence of CD is 21.3% in siblings, 14.7% in offspring, 17.2% in first-degree relatives, 19.5% in second-degree relatives, and 17.8% in all relatives. Research found that the people diagnosed with celiac disease are a sub-population of a much larger group with gluten allergy. The gastrointestinal tract is the primary target organ; however systemic disease is an important consequence of cereal grain ingestion in many patients. The villi lining in the small intestine becomes damaged, which interferes with the body's ability to absorb vital nutrients. This damage and the corresponding lack of nutrients getting into the bloodstream, puts celiac's at risk for other health problems such as osteoporosis, miscarriage and congenital malformation, seizures, short stature, carcinomas of the gastrointestinal tract, cancers like lymphoma, adenocarcinoma of the small intestine, carcinoma of the pharynx and esophagus and inflammatory lung disease. The increased risk of carcinoma of the esophagus may be related to vitamin A deficiency. Because celiac patients have increased gastrointestinal permeability they demonstrate the whole-body effects of food allergy, including brain dysfunction, conditions with chronic tissue inflammation, especially arthritis, and the skin disorders, eczema, and dermatitis herpetiformis. A number of reports have indicated an increased prevalence of various types of chronic hepatitis in patients with celiac disease, but no coherent view of the cause of this association has emerged. Similarly, patients with celiac disease have been reported to have various forms of fibrosing lung disease of uncertain causation. In recent years, there have been several reports, mainly from Italy, of a syndrome of epilepsy and bilateral brain calcification occurring in celiac patients. The pathogenesis of this condition is not known and its prevalence in other communities is uncertain. Splenic atrophy occurs frequently in patients with celiac disease and is related to the severity of the disease and degree of dietary control. Splenic atrophy predisposes to infection with capsulated bacteria, although mortality studies indicate that infection with these organisms is not a major cause of death in patients with celiac disease. About 4% of migraine sufferers may have celiac disease and symptom control may be improved with a gluten-free diet, according to the results of a study published in the American Journal of Gastroenterology. Latent disease may manifest as irritable bowel syndrome, sometimes with iron deficiency anemia, but little or no diarrhea. The digestive process is also impaired making food allergies more common in those with celiac disease. The classic presentation of celiac disease is chronic diarrhea, with abdominal bloating, sometimes pain, weight loss, iron deficiency and other evidence of nutrient malabsorption. Common complaints would be chronic diarrhea and extreme weight loss. Most celiacs have symptoms that are far more wide ranging such as:
Some celiacs never experience any gastrointestinal problems or symptoms, even while the lining of the small intestine (villi) is being continually damaged with the result being malnutrition despite an adequate diet. Doctors can do blood tests that search for four specific antibodies. If any of the four antibodies is found, a diagnosis of celiac is likely. However, true confirmation comes from a biopsy taken from the small intestine. Intestinal biopsy reveals pathological manifestation of gluten allergy. When the diagnosis is made, a gluten-free diet is prescribed. Since a strict gluten-free diet is protective against the consequences of gluten allergy, it is important that diagnosed forms of celiac disease and non-celiac "gluten allergy" are treated with diet revision. Celiac disease can only be controlled by strict, life-long adherence to a diet free of gluten. Individuals with Celiac disease avoid: Breads and all foods containing wheat, rye, tritical (a hybrid grain of wheat and rye), barley, oats, wheat germ or bran, graham, gluten or durum flour, wheat starch, oat bran, bulgur farina, wheat based semolina, spelt, and kamut. Also, avoided are malt extract and malt flavorings. The celiac diet replaces the aforementioned with: Breads or products made with corn, rice, soy, arrowroot, corn or potato starch, whole bean flour, tapioca, sago, rice bran, cornmeal, buckwheat, millet, flax, teff, sorghum, amaranth, and quinoa. In conclusion, Gluten-caused diseases are curious diseases that confuse everyone who has them, treats them or studies them. All nutritional recommendations encourage you to eat bread; the more whole wheat, the better. Bread, pasta, hamburgers, hot dogs, pizzas are normal fast foods and many people eat these foods for dinner. The confusion arises when evidence accumulates that bread can make some people chronically ill. Bread can cause autoimmune disease. Bread can cause cancer if you have celiac disease and continue to eat gluten. The task of a person with gluten disease is to live in a bread culture without eating bread. How can anyone accept such a deviant path? For more information concerning celiac disease please contact the following sources… Visit OKinHealth Celiac page Penticton Support Group - Les Erucker (250) 493-6381 Interior Health Registered Dietician; Maureen.Green@interiorhealth.ca or Web: www.interiorhealth.ca medical practitioner; or The Canadian Celiac Association 1-800-363-7296.web site is www.celiac.ca/ Bibliography: Canadian Celiac Association and American Celiac Association Submitted by Anniteh Zanne z28@telus.net
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