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Celiac Disease
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| Wednesday, September 30th, 2009 | | CWK Producer |
“The striking finding was patients that had no real risk factors, no symptoms whatsoever, were carrying the disease.”
– Benjamin Gold, M.D., director of gastroenterology and nutrition at Emory University
A study by the Mayo Clinic finds that celiac disease, an auto-immune reaction to gluten, is four times more common today than it was 50 years ago. In fact, today one in 100 Americans can’t handle the protein commonly found in bread, pizza and cookies. Is your child at risk?
At age 2, little Martha was losing weight, not growing taller and her stomach was abnormally large.
“She looked typically like one of those malnourished children that you’ll see on TV or in magazines,” recalls Greer Pope, Martha’s mother.
Martha has celiac disease, an allergy to the protein gluten found mostly in wheat, barley and rye. Gluten damages the small intestine and prevents nutrients from being absorbed. The symptoms of the disease can sometimes be severe.
“Patients will come in with everything from belly pain to bloating, distention, diarrhea [among other things],” says Dr. Benjamin Gold, director of gastroenterology and nutrition at Emory University.
Celiac is common in Europe, but a study by the Mayo Clinic finds that one in 100 Americans suffer from it, often undiagnosed.
“The striking finding was patients that had no real risk factors, no symptoms whatsoever, were carrying the disease,” Dr. Gold says.
In other words, far more people have the disease, but they don’t know it because they have few symptoms or none and few doctors screen for it.
Experts say if your child has reoccurring stomach problems a test for celiac may be a good idea, but, says Dr. Gold, “In a person who is completely asymptomatic, who has no relatives, no risk factors, I would be less inclined to say you should worry.”
The only treatment for celiac disease is a gluten-free diet. It’s one that Martha, now 3, follows closely. She’s slowly getting better, and that’s a great comfort to her mother.
“It’s definitely nice to know what it is, and it’s very treatable. In the grand scheme of things, there is a whole lot worse out there,” Pope says.
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According to the National Digestive Diseases Information Clearinghouse (NDDIC), celiac disease is a digestive disorder that damages the small intestine and interferes with absorption of nutrients from food. People who suffer the disease cannot tolerate a protein called gluten, which is found in wheat, rye, barley and possibly oats. When a person with celiac disease eats foods containing gluten, his or her immune system responds by damaging the small intestine.
In one study published in the Archives of Internal Medicine, researchers screened a total of 13,145 subjects for celiac disease (CD): 4,508 first-degree relative (sibling, child or parent with CD) and 1,275 second-degree relatives (grandparent, aunt, uncle or cousin) of patients with biopsy-proven CD, 3,236 symptomatic patients (with either gastrointestinal symptoms or a disorder associated with CD) and 4,126 not-at-risk individuals.
Study results revealed that in at-risk groups, the prevalence of CD was 1:22 in first-degree relatives and 1:39 in second-degree relatives. In a sample of people with classical gastrointestinal symptoms of the condition or one of the related disorders, researchers discovered that one in 56 had celiac disease. The overall prevalence of CD in not-at-risk groups was 1:133 among people with no genetic risk factors for or symptoms of celiac disease but who did, in fact, have the condition. Researchers suggest that if left untreated, celiac disease may lead to other conditions, such as osteoporosis, due to inadequate intake of calcium or other nutrients.
Experts at the University of Chicago say that CD affects people differently. Some develop symptoms as children, others as adults. CD is a genetic disease, meaning that it runs in families. Sometimes it is triggered – or becomes active for the first time – after surgery, pregnancy, childbirth, viral infection or severe emotional stress.
Symptoms of CD are as varied as the nutritional deficiencies caused by the malabsorption. Infants, toddlers and children may exhibit growth failure, vomiting, a bloated abdomen and behavioral changes. The Celiac Disease Foundation cites the following symptoms that may indicate your child suffers from CD:
- Abdominal cramping
- Intestinal gas
- Distention and bloating
- Chronic diarrhea or constipation (or both)
- Steatorrhea (oily stools)
- Anemia – unexplained due to folate, B12, B6 or iron deficiency (or all)
- Weight loss, with large appetite, or weight gain
- Dental enamel defects
- Osteopenia, osteoporosis
- Bone or joint pain
- Fatigue, weakness and lack of energy
- Infertility
- Depression
Diagnosis of CD is readily available; however, no cure for the disease exists. The Mayo Clinic suggests that if someone in your family is known to have CD, other members may need to be tested. This will help you avoid complications associated with not treating the disease. Research has revealed that people with CD carry higher-than-normal levels of certain antibodies, and a blood test can help diagnose the problem. To confirm the diagnosis, your doctor may remove (biopsy) a small portion of intestinal tissue to check for damage.
If left untreated, damage to the small intestine and the resulting problems with nutrient absorption put a person with CD at risk for several diseases and health problems. The NDDIC cites the following health risks associated with CD:
- Lymphoma and adenocarcinoma
- Osteoporosis
- Miscarriage and congenital malformation
- Short stature
- Seizures or convulsions
Only one course of treatment exists for celiac disease sufferers, child or adult. The Children’s Digestive Health and Nutrition Foundation states that the only treatment necessary is absolute avoidance of gluten-containing foods. The widespread use of gluten-containing grains in Western cultures makes adapting to a gluten-free diet challenging. For parents used to preparing gluten-containing meals, searching for and cooking with gluten-free products may seem strange at first.
References
- Archives of Internal Medicine
- Celiac Disease Foundation
- Children’s Digestive Health and Nutrition Foundation
- Mayo Clinic
- National Digestive Diseases Information Clearinghouse
- University of Chicago
