Celiac Disease: What's the Deal?
With all the gluten-free labeling at the supermarket, you might think celiac disease has gone viral. Actually, 1 in 133 Americans has celiac disease, but it affects 10% of people with type 1 diabetes. Celiac disease remains poorly understood, but that's changing.
When people with celiac disease eat gluten, a protein found in barley, wheat, and rye, their immune systems attack their small intestines. The disease causes poor absorption of nutrients. Untreated celiac disease can lead to osteoporosis, infertility, neurological conditions, and rarely, cancer. "If you put a celiac patient on a gluten-free diet, that will tremendously improve symptoms," according to Bana Jabri, MD, Ph.D, director of research at the University of Chicago Celiac Disease Center.
The traditional view of celiac disease has been that it strikes in childhood, causing children to become underweight and to have chronic diarrhea, but this perception is changing. The bulk of patients being diagnosed in this country are adults. Most have atypical symptoms and adults aren't necessarily underweight, according to Dr. Jabri.
Doctors now know that celiac disease can cause a wide range of symptoms that can seem puzzling, or no symptoms at all. A 2003 study found that only 35% of celiac patients have chronic diarrhea, while around half lack any obvious symptoms. Vitamin deficiencies may be one indicator. So, what are the symptoms of celiac disease? National Digestive Information Clearinghouse lists the following symptoms (progressive order):
1) abdominal bloating and pain
2) chronic diarrhea
3) pale, foul-smelling, or fatty stool
4) vomiting
5) constipation
6) fatigue
7) weight loss
8) canker sores
9) unexplained iron-deficiency anemia
10) itchy skin rash called dermatitis herpetiformis
11) tingling numbness in hands and feet
12) bone or joint pain
13) arthritis
14) bone loss or osteoporosis
15) missed menstrual periods (women)
16) infertility or recurrent miscarriage (women)
Some diagnostic confusion arises from the fact that many people who test negative for celiac disease still report ill effects from gluten. This condition is called gluten intolerance or gluten sensitivity, but Dr. Jabri stresses that for most people there is no health advantage to eating gluten-free products. In fact, if you don't have celiac disease or gluten intolerance, avoiding gluten could cause a nutrient imbalance.
People with celiac disease often become food-label sleuths. Evan a tiny amount of gluten can cause problems for them. The Food and Drug Administration (FDA) is working to develop a definition of "gluten-free" so that consumers can know just what they are getting when they see the term on food labels. As of now, there isn't an approved definition of gluten-free. The FDA is reviewing comments from the public on a gluten-free standard, and the agency is expected to rule soon. Any product with wheat must be clearly labeled. It's also important to scan the ingredients for rye and barley, modified food starch, triticale and meat fillers, too.
For more information on celiac disease, check out www.celiac.org and www.celiac.nih.gov.
Closing Thought
Make every day a great day!
Johanna Hicks, B.S., M.Ed.
Extension Family & Consumer Sciences Agent
Hopkins County
1200-B W. Houston
P.O. Box 518
Sulphur Springs, TX 75483
903-885-3443 - phone
903-439-4909 - fax
jshicks@ag.tamu.edu
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