Sensitive to Gluten or Suffering from Celiac Disease?
by Dr. Elie Abemayor MD, Chief of Gastroenterology, Northern Westchester Hospital.
Just 10 years ago, Americans with celiac (SEE-lee-ak) disease had a tough time getting a diagnosis. Doctors thought that the autoimmune digestive disorder was extremely rare in this country. However, recent studies suggest that at least 1 percent of the US population—about 3.5 million—may have this genetic condition, which causes symptoms like bloating, abdominal pain, and diarrhea and can lead to malnutrition and thinning bones. Even worse: Up to 83 percent of them don’t realize they have it, according to statistics from the National Foundation for Celiac Awareness. People used to think that celiac disease was primarily a problem in Northern Europe, now we know that we’re pretty much comparable.
The trouble starts with the body’s overreaction to gluten, a protein in wheat, barley, and rye. This damages tiny hair-like structures in the small intestine that are responsible for gleaning vitamins, minerals, fat and other nutrients from food. In some children, celiac disease can stunt mental and physical development. In adults it can lead to anemia, skin conditions, osteoporosis, and even some types of bowel cancer.
The symptoms of celiac disease are tough to bear at any age: Along with the bloating and diarrhea, sufferers can have fatigue, irritability or depression, joint pain, and weight loss. The wide variety of symptoms made celiac tough to diagnose. Now, however, blood tests and genetic scans can help identify the disease. Obviously, people who are symptomatic should be tested, he says, especially those who have a family member with the disorder or those who have other autoimmune conditions such as Type 1 Diabetes Mellitus or thyroid disease.
Doctors confirm the presence of celiac with an endoscopy and biopsy of the small intestine. The next step for the patient is to eliminate gluten from their diet. While this was once a daunting prospect, there are more and more gluten-free products available. It’s getting much easier to avoid wheat, barley, and rye. Even if you don’t have diagnosable celiac disease, you may still want to try going gluten-free if you suffer persistent stomach distress. There is a subset of people who are merely gluten-sensitive and they may benefit by avoiding it.
Editor’s note: See also post by NWH Registered Dietitian on a gluten free diet.