Coeliac Disease

Coeliac disease, also known as gluten intolerance, is a genetic disorder that affects 1 in 133¹ Americans. Symptoms of coeliac disease can range from the classic features, such as diarrhea, weight loss, and malnutrition, to latent symptoms such as isolated nutrient deficiencies but no gastrointestinal symptoms. The disease mostly affects people of European (especially Northern European) descent, but recent studies show that it also affects Hispanic, Black and Asian populations as well¹. Those affected suffer damage to the villi (shortening and villous flattening) in the lamina propria and crypt regions of their intestines when they eat specific food-grain antigens (toxic amino acid sequences) that are found in wheat, rye, and barley³. Oats have traditionally been considered to be toxic to coeliacs, but recent scientific studies have shown that this is not the case.

Because of the broad range of symptoms coeliac disease presents, it can be difficult to diagnose. The symptoms can range from "mild weakness, bone pain, and aphthous stomatitis to chronic diarrhea, abdominal bloating, and progressive weight loss.³" If a person with the disorder continues to eat gluten, studies have shown that he or she will increase their chances of gastrointestinal cancer by a factor of 40 to 100 times that of the normal population⁴. Further, "gastrointestinal carcinoma or lymphoma develops in up to 15 percent of patients with untreated or refractory coeliac disease³." It is therefore imperative that the disease is quickly and properly diagnosed so it can be treated as soon as possible.

Based on the figure mentioned above we can extrapolate the total number of people in the United States with coeliac disease: 2.18 million (based on the total population: 290,356,028⁵). It is very important that doctors understand just how many people have this disease so that routine testing for it is done to bring the diagnosis rate in line with the disease's epidemiology. Testing is fairly simple and involves screening the patient's blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis.

The only acceptable treatment for coeliac disease is strict adherence to a 100% gluten-free diet for life. An adherence to a gluten-free diet can prevent almost all complications caused by the disease³. A gluten-free diet means avoiding all products that contain wheat, rye and barley, or any of their derivatives. This is a difficult task as there are many hidden sources of gluten found in the ingredients of many processed foods.

Symptoms

Celiac Disease may appear at any time in a person's life. The disease can be triggered for the first time after surgery, viral infection, severe emotional stress, pregnancy or childbirth. CD is a multi-system, multi-symptom disorder. Symptoms are extremely varied and can often mimic other bowel disorders. Infants, toddlers, and children often exhibit growth failure, vomiting, bloated abdomen and behavioral changes.

Classic symptoms may include:

• abdominal cramping, intestinal gas, distention and bloating
• chronic diarrhea or constipation (or both)
• steatorrhea -- fatty stools
• anemia - unexplained, due to folic acid, B12, or iron deficiency (or all)
• weight loss with large appetite, or weight gain

Other symptoms:

• dental enamel defects
• osteopenia, osteoporosis
• bone or joint pain
• fatigue, weakness and lack of energy
• infertility - male/female
• depression
• Aphthous ulcers

Dermatitis Herpetiformis (DH) is skin manifestation of celiac disease characterized by blistering, intensely itchy skin. The rash has a symmetrical distribution and is most frequently found on the face, elbows, knees and buttocks. DH patients can have gastrointestinal damage without perceptible symptoms.