Gluten Intolorance

Bamberger Health and Wellness -- Everett and Lynnwood, WA -- (425) 355-4176

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Gluten Intolerance (Celiac Disease)

 It is estimated that about 1% of all people suffer from a gluten allergy or intolerance.

Celiac disease (CD) - otherwise known as celiac sprue, or gluten sensitive enteropathy (GSE) - is an inherited autoimmune disorder that occurs in response to the ingestion of the dietary proteins (gluten and gliadin) found in wheat, rye, and barley. This response leads to inflammation in the intestines and to the damage and destruction of the villi in the lining of the intestinal wall. These villi are projections (small folds) that increase the surface area of the intestines and allow nutrients, vitamins, minerals, fluids, and electrolytes to be absorbed into the body. When the villi are destroyed the body is much less capable of absorbing food and begins to develop symptoms associated with malnutrition and malabsorption.

The damage and inflammation seen with celiac disease is caused by autoantibodies. When the body is exposed to the proteins gluten and gliadin it forms antibodies against not only these proteins, but also against the intestines. As long as the patient continues to be exposed to the proteins they will continue to produce the autoantibodies and damage their intestines.

To Develop Celiac Disease:

(1) you must inherit the gene
(2) consume gluten
(3) have the gene triggered. Common triggers may include stress, trauma (surgeries, pregnancy, etc.), and viral infections.
Approximately 1 in 20 first-degree relatives could have CD triggered in their lifetime. The disease is permanent and damage to the small intestine will occur every time you consume gluten, regardless of whether symptoms are present or not.

Symptoms of Celiac Disease

Celiac disease was once thought of a disease with only gastro-intestinal symptoms. Typical symptoms of celiac disease include diarrhea, weight loss, abdominal pain, chronic fatigue, weakness, malnutrition, and other gastrointestinal problems including constipation, constipation alternating with diarrhea. In children the symptoms may include failure to thrive (an inability to grow and put on weight), irritability, an inability to concentrate, diarrhea and bloating. Another common symptom is premature osteoporosis.

It is now recognized as a disease is a multi-symptom, multi-system (organ) disease. Often it does not present with the 'textbook' symptoms that physicians learned about in school (diarrhea, bloating, weight loss, anemia, chronic fatigue, weakness, bone pain, and muscle cramps). Instead it presents with symptoms that can mimic other problems, some of which do not involve the small intestine at all.  Overweight persons may also have undiagnosed celiac disease.

Children may exhibit behavioral, learning or concentration problems, irritability, diarrhea, bloated abdomen, growth failure, dental enamel defects, or projectile vomiting. Others will have symptoms such as rheumatoid conditions, chronic anemia, chronic fatigue, weakness, migraine headaches, nerve problems such as tingling of hands or difficulty walking, or other conditions that are unexplained and/or do not respond to usual treatment. People may have one or more of the above symptoms. Patients are frequently misdiagnosed as having 'irritable bowel syndrome', 'spastic colon/bowel', or Crohn's disease'.

People affected by Celiac Disease may experience non-intestinal symptoms that involve many systems and organs including bones (osteoporosis, arthritis, and joint pain), blood (anemia and bleeding), reproductive system (infertility and reoccurring abortion), nervous system (chronic fatigue syndrome, depression, dementia), and behavioral changes.

Diagnosis

At Bamberger Health and Wellness initial screening for gluten intolerance is done as part of an over-all lifestyle makeover that identifies toxins and allergens and optimizes your lifestyle. Our doctors may then follow up with further testing, such as a blood test, called the Celiac Panel. If indicated you may then be referred to a gastroenterologist for a small intestine tissue biopsy. A biopsy showing damaged villi in the small intestine is the first half of the 'Gold Standard' to diagnosing CD. The second half of the 'Gold Standard' is improvement of health with the gluten-free diet. It is important to note that in some situations an individual may have a normal blood panel and still have celiac disease. Confirmation of CD will help future generations be aware of the risk of CD within the family.

Related Disorders

Dermatitis herpetiformis is also present in some people with celiac disease. Other autoimmune disorders that people with CD are at greater risk to develop include Addison' s disease, autoimmune chronic active hepatitis, Alopecia Areata, Graves' disease, insulin-dependent diabetes mellitus (type 1), myasthenia gravis, scleroderma, Sjogren's syndrome, lupus, and thyroid disease. Thyroid diseases and diabetes are the two most commonly associated diseases found with celiac disease. Thyroid disease is most commonly associated with DH.

Other conditions frequently seen in persons with gluten intolerance include anemia, early bone disease, Downs Syndrome, and fertility problems. Some persons with DH also have a higher incidence of other skin conditions, such as eczema. Other connections have been suggested - such as with autism, MS, and mycosis fungoides - but the research is inclusive.

Treatment

Strict adherence to a gluten-free diet for life is the only treatment currently available. This involves the elimination of wheat, rye, barley, and derivatives of these grains from your diet. Medication is not normally required, unless there is an accompanying condition, e.g. osteoporosis, dermatitis herpetiformis, etc. Thriving, showing improvement and return of health on the gluten-free diet is the second half of the 'gold standard' of being diagnosed with CD.

 Associated food intolerances

People with gluten intolerance may also experience other food and environmental sensitivities. At Bamberger Health and Wellness, our doctors will evaluate you to determine if this is the case for you.

Nutritional Supplements

The consumption of gluten by gluten intolerant individuals can damage the small intestine, causing a reduction in the assimilation of nutrients from the intestine into the blood stream ,which carries the nutrients to the cells. While nutritional supplements can help replace nutritional deficiencies that are common in celiac disease, many supplements are from gluten sources. It is important to use gluten-free supplements.

Prognosis

Excellent, if you stay on the gluten-free diet. The small intestine will steadily heal and start absorbing the needed nutrients. You should start feeling better almost immediately; however, complete recovery may take several months to years.

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Gluten-Free Diet
Gluten-Free Recipes
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