Celiac Disease from Health Magazine
2008-11-19 09:25:34http://www.health.com/health/mindbody/article/0,15669,534439,00.html
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Need a celiac anti body test to determine if the disease is present.
Hidden Intolerance to Wheat
A disease known for causing chronic diarrhea and weight loss often doesn't. As
a result, many people may not know they have it -- and this is particularly
worrisome for women, because a missed diagnosis could mean years of silent
damage to their bodies.
The condition is called celiac disease (CD), an intolerance to a protein called
gluten found in wheat, rye, barley, and oats. Just one in 15,000 people is
diagnosed with it. But according to new research, CD may affect as many as one
in 133 people, or about 2 million Americans, most of them women.
Left unchecked, CD can cause a laundry list of serious problems, including
osteoporosis, anemia, infertility, an increased risk of intestinal cancers, and
behavioral changes such as memory loss and mood swings, says Alessio Fasano,
M.D., director of the Center for Celiac Disease Research at the University of
Maryland. Research is finding that CD is often hard to detect.
In a recent Indian study of 33 women with painful early-onset osteoporosis, 13
were found to have the disease but none had any recent diarrhea, a signature
symptom of CD. Typical treatment -- removing gluten from the diet -- relieved
their pain within three months and improved their bone density within a year.
In another trial, about 5 percent of people with migraines were found to have
CD; treatment for it cured or reduced the headaches.
Doctors might have trouble diagnosing CD because the symptoms are often no
different from everyday complaints. A team led by Robert D. Zipser, M.D., a
gastroenterologist and clinical professor of medicine at Harbor-UCLA Medical
Center in Torrance, California, recently surveyed more than 1,000 people from a
CD support group. Only half had frequent diarrhea, and only 32 percent were
underweight. A follow-up survey found that fatigue, abdominal pain, and gas were
their most common symptoms. On average, a year elapsed before the patients
received a correct diagnosis; for one in five, the wait was more than 10 years.
They were most often told they had irritable bowel syndrome, anxiety or
depression, or fibromyalgia.
The disease is hereditary. The most serious cases occur in children, but adults
can develop it at any time, particularly after surgery or pregnancy, or as a
result of stress. CD is an autoimmune disorder, meaning your own immune cells
attack your body. In this case, they destroy the lining of your intestines.
Conditions such as osteoporosis and anemia develop in people with CD because the
intestinal damage interferes with nutrient absorption. That's true no matter how
much you eat and even if you're lucky enough to avoid diarrhea, a major cause of
nutrient loss.
A blood test can confirm that you have CD. But Fasano doesn't think asymptomatic
people should be screened for the disease since the remedy can be Draconian:
avoiding all foods containing gluten -- including most breads, pasta, and
cookies -- and exercising extreme caution when eating processed foods, many of
which contain gluten as an unlisted additive. Still, Zipser advises people who
have irritable bowel syndrome, chronic fatigue, or fibromyalgia that doesn't get
better after treatment to ask their doctors for a celiac-antibody test.
--Eric Steinmehl